Rare Diseases Symptoms Automatic Extraction
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Screening for obstructive sleep apnea in children with syndromic cleft lip and/or palate.
[22q11.2 deletion syndrome]
Craniofacial
malformations
including
cleft
lip
and
/
or
palate
(
CL
/
P
)
increase
risk
for
obstructive
sleep
apnea
(
OSA
)
.
While
30
%
of
CL
/
P
occurs
in
the
context
of
underlying
genetic
syndromes
,
few
studies
have
investigated
the
prevalence
of
OSA
in
this
high
-risk
group
.
This
study
aims
to
determine
the
incidence
and
risk
factors
of
positive
screening
for
OSA
in
this
complex
patient
population
.
The
Pediatric
Sleep
Questionnaire
(
PSQ
)
was
prospectively
administered
to
all
patients
cared
for
by
the
cleft
lip
and
palate
clinic
at
the
Children
's
Hospital
of
Philadelphia
between
January
2011
and
August
2013
.
The
PSQ
is
a
22
-
item
,
validated
screening
tool
for
OSA
with
a
sensitivity
and
specificity
of
0
.
83
and
0
.
87
in
detecting
an
apnea
-hypopnea
index
(
AHI
)
>
5
/
hour
in
healthy
children
.
The
Fisher
exact
and
Chi
-square
tests
were
used
for
purposes
of
comparison
.
178
patients
with
syndromic
CL
/
P
completed
the
PSQ
.
Mean
cohort
age
was
8
.
1
Â
±
Â
4
.
4
years
.
Patients
were
predominately
female
(
53
.
9
%
)
,
Caucasian
(
78
.
1
%
)
,
and
had
Veau
Class
II
cleft
(
50
.
6
%
)
.
Craniofacial
syndromes
included
isolated
Pierre
Robin
Sequence
(
PRS
)
(
29
.
8
%
)
,
22
q
11
.
2
deletion
syndrome
(
14
.
6
%
)
,
Van
der
Woude
syndrome
(
6
.
7
%
)
,
and
other
rare
genetic
abnormalities
(
28
.
8
%
)
.
The
overall
incidence
of
positive
OSA
screening
was
32
.
0
%
.
Males
were
at
increased
risk
for
positive
OSA
screening
(
P
Â
=
Â
0
.
030
)
,
as
were
non-
Caucasians
(
P
Â
=
Â
0
.
044
)
.
Symptoms
with
the
highest
positive
predictive
value
for
OSA
were
"
others
comment
on
child
appearing
sleepy
"
(
76
.
2
%
)
and
"
stops
breathing
during
the
night
"
(
75
.
0
%
)
.
Notably
,
patients
with
22
q
11
.
2
deletion
syndrome
were
at
highest
risk
for
positive
screens
(
50
.
0
%
,
P
Â
=
Â
0
.
042
)
.
Nearly
a
third
of
our
patients
with
syndromic
CL
/
P
screened
positively
for
OSA
(
32
.
0
%
)
,
highlighting
the
importance
of
screening
in
this
at
-risk
population
.
Future
work
will
correlate
screening
results
with
polysomnograms
to
help
validate
these
findings
.
Diagnostic
,
III
.
Diseases
Validation
Diseases presenting
"cleft lip"
symptom
22q11.2 deletion syndrome
dentinogenesis imperfecta
kabuki syndrome
kallmann syndrome
monosomy 21
oligodontia
wolf-hirschhorn syndrome
This symptom has already been validated