Document Detail


Efficacy of uvulopalatopharyngoplasty in unselected patients with mild obstructive sleep apnea.
MedLine Citation:
PMID:  10964287     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Uvulopalatopharyngoplasty (UPPP) is widely used as a first-step procedure for the surgical management of obstructive sleep apnea (OSA) syndrome but best manages obstruction occurring at the level of the oropharynx alone and not the hypopharynx. Previous publications have noted mediocre results with use of this procedure in unselected patients with OSA, but less clear is the effectiveness of this procedure in the unselected patient with mild OSA (respiratory event index [REI] 5-25). Using objective and subjective criteria, we retrospectively analyzed the results of UPPP in patients with mild OSA. METHODS: We examined 37 patients with mild OSA (REI 13.5 +/- 5.1, range 5.6-23.1) who had been operated on during 1996 with UPPP with or without tonsillectomy and/or septoplasty. Follow-up polysomnography was obtained in 25 (68%) an average of 40.5 weeks after surgery and compared with findings before surgery. Subjective assessment of sleepiness was performed with the Sleep-Wake Activity Inventory. RESULTS: Ten patients (40%) had a postoperative reduction in the REI of more than 50%, comparable with the improvements reported in those with more severe apnea. Those who did not have a reduction in REI after surgery actually saw an increase in average REI from 16.6 +/- 5 to 26.7 +/- 18.4. Similarly, subjective assessment of sleepiness with the Sleep-Wake Activity Inventory showed no statistically significant improvement after surgery. CONCLUSION: Overall, these results indicate that UPPP alone in the unselected patient provides little benefit in the management of mild OSA, similar to findings for more severe OSA. Surgeons must use great care in discerning the level of obstruction in the patient with mild OSA to tailor the appropriate retropalatal and/or retrolingual procedures and thereby achieve excellent surgical outcomes.
Authors:
B A Senior; L Rosenthal; A Lumley; R Gerhardstein; R Day
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery     Volume:  123     ISSN:  0194-5998     ISO Abbreviation:  Otolaryngol Head Neck Surg     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2000-10-05     Completed Date:  2000-10-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8508176     Medline TA:  Otolaryngol Head Neck Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  179-82     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, 27599-7070, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Humans
Male
Middle Aged
Otorhinolaryngologic Surgical Procedures
Palate / surgery*
Pharynx / surgery*
Polysomnography
Retrospective Studies
Sleep Apnea, Obstructive / surgery*
Treatment Outcome
Uvula / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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