The effect of Le Fort III procedure in the treatment of obstructive sleep apnea in children with syndromic craniosynostosis

Obstructive sleep apnea (OSA) is common in children with syndromic craniosynostosis (SC). The efficacy of the Le Fort III procedure in managing OSA in children with SC remains a subject of ongoing debate. This study aimed to explore the efficacy of Le Fort III procedure in the management of OSA in children with SC.

A retrospective study was performed in children with SC and OSA diagnosed by polysomnography, which was defined as an apnea-hypopnea index ≥ 1 event/h. Patients meeting the inclusion criteria were those who underwent Le Fort III surgery and had both baseline polysomnography and follow-up sleep studies. Relevant clinical and demographic data were collected from all individuals who participated in the study.

Overall, 45 children with OSA and SC were identified, with a mean age of 6.8 ± 4.7 years. Twenty-five received the Le Fort III procedure and follow-up sleep studies. The Le Fort III procedure resulted in a significant reduction in apnea-hypopnea index (6.0 [2.6, 10.1] vs 37.6 [20.9, 48.0] events/h; P < .001). However, normalization of OSA was only achieved in 1 patient (4%).

The Le Fort III procedure is efficacious in the treatment of OSA in children with SC. However, despite the observed improvement, residual OSA following treatment remains common.

Chang Y, Zhang W, Li M, et al. The effect of Le Fort III procedure in the treatment of obstructive sleep apnea in children with syndromic craniosynostosis. J Clin Sleep Med. 2024;20(8):1301–1311.