Obstructive Sleep Apnea Following Palatoplasty in a Patient with Pierre-Robin Sequence--One Case Report

　　　　　顎修補術後，上呼吸道阻塞可說是嚴重的併發症，但正常的呼吸道是很少發生。上呼吸道阻塞會在顎修補術後，一些特定顱顏畸型的病人發生（如Treacher Collin症侯群、Turner's症侯群、Pierre-Sequence症侯群、Down症侯群等）。從1996年一月到1997年12月期間，二年中共有254病人進行顎修補術，我們有一例嚴重的阻塞性睡眠呼吸暫停，發生在一Pierre-Robin症侯群病人，須要經過緊急插管及連續給予呼吸道正壓，而恢復自發性呼吸。在這病例報告中，將描述我們醫院中，自1995年後對顎修補術後的病人，對呼吸道的處理，及呼吸道併發症的治療。
　　　　　Upper airway obstruction is described as one of major complications of cleft palte repair, but the frequency is very low in the normal airway infant. However, upper airway obstruction is encountered after palatoplasty with certain craniofacial abnormalities (e.g., Treacher Collins syndrome, Turner's syndrome, Pierre-Robin syndrome, and Down's syndrome, etc.). In 254 cases with the palatoplasty between January 1996 and December 1997, we experience one obstructive sleep apnea after the palatoplasty in a child with Pierre-Robin sequence. Emergency intubation and nasal continuous positive airway pressure (CPAV) were required for restoration of spontaneous respiration. In this paper, we describe the protocol, airway management of cleft palate repair after 1995 and the treatment of the airway complication after palatoplasty in our hospital.