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Palatal and tongue base surgery for surgical treatment of obstructive sleep apnea: a prospective study.
Otolaryngology - Head and Neck Surgery 2006 August
OBJECTIVE: To assess the effect of concurrent uvulopalatopharyngoplasty (UPPP) and hypopharyngeal procedures in obstructive sleep apnea (OSA) patients with diffuse airway narrowing.
STUDY DESIGN AND SETTING: Forty-eight patients were treated surgically by a single surgeon in private practice over 2 years. Symptoms, Epworth score, and polysomnographic outcome were assessed preoperatively and postoperatively. The Friedman staging system was applied. UPPP with genioglossus advancement, hyoid suspension, or radiofrequency treatment was carried out.
RESULTS: In 37 patients with complete data, the average apnea-hypopnea index (AHI) was reduced from 46.5 +/- 24.8 to 14.9 +/- 16.8. The Epworth score was reduced from 12.1 +/- 4.9 to 6.7 +/- 3.7. Most patients reported improved sleep quality, alertness, memory, concentration, and mood.
CONCLUSION: Successful outcome, defined by symptom and AHI reduction, was achieved with multilevel surgery for most patients with advanced Friedman stages 2 and 3.
SIGNIFICANCE: Multilevel surgery seems effective in treating severe OSA patients with diffuse airway narrowing.
EBM RATING: C-4.
STUDY DESIGN AND SETTING: Forty-eight patients were treated surgically by a single surgeon in private practice over 2 years. Symptoms, Epworth score, and polysomnographic outcome were assessed preoperatively and postoperatively. The Friedman staging system was applied. UPPP with genioglossus advancement, hyoid suspension, or radiofrequency treatment was carried out.
RESULTS: In 37 patients with complete data, the average apnea-hypopnea index (AHI) was reduced from 46.5 +/- 24.8 to 14.9 +/- 16.8. The Epworth score was reduced from 12.1 +/- 4.9 to 6.7 +/- 3.7. Most patients reported improved sleep quality, alertness, memory, concentration, and mood.
CONCLUSION: Successful outcome, defined by symptom and AHI reduction, was achieved with multilevel surgery for most patients with advanced Friedman stages 2 and 3.
SIGNIFICANCE: Multilevel surgery seems effective in treating severe OSA patients with diffuse airway narrowing.
EBM RATING: C-4.
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