Document Detail


Retropalatal airway characteristics in uvulopalatopharyngoplasty compared with transpalatal advancement pharyngoplasty.
MedLine Citation:
PMID:  9185728     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Uvulopalatopharyngoplasty (UPPP) is reported successful in treatment of obstructive sleep apnea for approximately 50% of patients. Several modifications of the procedure have been described, including transpalatal advancement pharyngoplasty, which resects a portion of posterior hard palate and advances the soft palate anteriorly. Comparing effectiveness of different techniques based on sleep and respiratory data is confounded by multiple variables including clinical failure at nonsurgical sites and imprecise patient selection techniques. Since pharyngeal surgical procedures prevent collapse and obstruction by structurally modifying the upper airway, measuring structural changes in size and collapsibility provides a method to compare techniques. To evaluate whether transpalatal advancement pharyngoplasty is more effective in modifying upper airway characteristics than UPPP, upper airway cross-sectional size and collapsibility were measured after UPPP and transpalatal advancement pharyngoplasty. Six patients were evaluated using a quantitative endoscopic technique. After transpalatal advancement pharyngoplasty maximal retropalatal airway size increased 321% from 29.7 +/- 9.9 to 95.3 +/- 16 mm2 (P < 0.01), and retropalatal closing pressure decreased from 4.7 +/- 1.6 to -3.8 +/- 0.7 cm/H2O (P < 0.01) compared with UPPP. Respiratory disturbance index decreased from 74.5 +/- 13.5 to 29.2 +/- 9 events/hour postoperatively (P < 0.05). Results support the conclusion that transpalatal advancement pharyngoplasty increases retropalatal size and decreases retropalatal collapsibility compared with UPPP. Since these characteristics are postulated to contribute to increased stability during sleep, transpalatal advancement pharyngoplasty may potentially improve UPPP outcome in selected patients with small retropalatal airway areas after traditional surgery.
Authors:
B T Woodson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  107     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-07-15     Completed Date:  1997-07-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  735-40     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology and Human Communication, Medical College of Wisconsin, Milwaukee, U.S.A.
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MeSH Terms
Descriptor/Qualifier:
Endoscopy
Humans
Otolaryngology / methods
Palate / surgery*
Pharynx / pathology*,  surgery*
Pressure
Sleep Apnea Syndromes / pathology*,  surgery*
Uvula / surgery

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


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