Craniofacial Syndromes

Children born with a variety of craniofacial conditions are at increased risk for obstructive sleep apnea (OSA). Craniofacial conditions encompass a wide spectrum of findings that can include cleft lip/palate, micrognathia, maxillary hypoplasia, macroglossia, and craniosynostosis, as well as other conditions with midface hypoplasia. In some cases, multilevel obstruction may be present. For many craniofacial conditions, infants may be at greatest risk for OSA. The complexity of the pediatric craniofacial patient is also compounded by the unique disease process of each patient and the spectrum of findings even within a specific syndrome. Treatment for OSA must be individualized, based on both the individual structural abnormalities and severity of sleep-disordered breathing. A variety of treatments for OSA are available and include both surgical and nonsurgical options. Identification of the underlying condition and determining the optimal management of OSA and associated comorbidities in this patient population may benefit from a multidisciplinary care team. Many craniofacial syndromes are rare, and additional research is needed to provide better evidence-based guidelines for the evaluation and management of OSA in these children.