Literature DB >> 11926920

Laser-assisted uvulopalatoplasty for the management of obstructive sleep apnea: myths and facts.

Yehuda Finkelstein1, Gideon Stein, Dov Ophir, Rachel Berger, Gilead Berger.   

Abstract

OBJECTIVE: To assess medium- to long-term subjective and objective results of laser-assisted uvulopalatoplasty (LAUP) for patients with obstructive sleep apnea.
DESIGN: A nonrandomized prospective before-after trial. SUBJECTS AND
INTERVENTIONS: Twenty-six patients underwent LAUP by means of vertical trenches along either side of the uvula and reduction of the uvula. MAIN OUTCOME MEASURES: Subjective analysis included a preoperative and 2 postoperative evaluations of the state of snoring: 4 weeks and a mean +/- SD of 12.3 +/- 9.1 months after completion of treatment. In addition, a score on 5 other sleep-related symptoms was recorded before treatment and after 12.3 +/- 9.1 months; at that time, patients also estimated their overall satisfaction with the procedure. Objective analysis included preoperative polysomnographic studies that were repeated postoperatively.
RESULTS: A significant decline in snoring improvement from 88% (23/26) to 65% (17/26) was recorded; furthermore, the state of snoring worsened from 4% (1/26) to 12% (3/26). Reevaluation of 5 other sleep-related symptoms after completion of LAUP uncovered a 50% improvement rate (13/26), and a 15% (4/26) worsening rate. Overall satisfaction from the procedure was 58% (15/26). Postoperative objective studies revealed that only 31% (8/26) of the procedures were successful, while 31% were associated with worsening of respiratory disturbance index. Fifty-four percent (14/26) of the patients had a sensation of pharyngeal dryness. In addition, 1 patient developed velopharyngeal stenosis.
CONCLUSIONS: The favorable subjective short-term results of LAUP deteriorated in time. Postoperative polysomnography revealed that LAUP might lead to deterioration of existing apnea. These findings are probably related to velopharyngeal narrowing and progressive palatal fibrosis inflicted by the laser beam.

Entities:  

Mesh:

Year:  2002        PMID: 11926920     DOI: 10.1001/archotol.128.4.429

Source DB:  PubMed          Journal:  Arch Otolaryngol Head Neck Surg        ISSN: 0886-4470


  9 in total

1.  [Guideline: Treatment of obstructive sleep apnea in adults].

Authors:  T Verse; R Bodlaj; R de la Chaux; A Dreher; C Heiser; M Herzog; W Hohenhorst; K Hörmann; O Kaschke; T Kühnel; N Mahl; J T Maurer; W Pirsig; K Rohde; A Sauter; M Schedler; R Siegert; A Steffen; B A Stuck
Journal:  HNO       Date:  2009-11       Impact factor: 1.284

Review 2.  The surgical treatment of sleep-related upper airway obstruction.

Authors:  Thomas Verse; Karl Hörmann
Journal:  Dtsch Arztebl Int       Date:  2011-04-01       Impact factor: 5.594

Review 3.  Surgical modifications of the upper airway for obstructive sleep apnea in adults: a systematic review and meta-analysis.

Authors:  Sean M Caples; James A Rowley; Jeffrey R Prinsell; John F Pallanch; Mohamed B Elamin; Sheri G Katz; John D Harwick
Journal:  Sleep       Date:  2010-10       Impact factor: 5.849

4.  Uvulopalatopharyngoplasty with an ultrasound scalpel or laser: is there a difference?

Authors:  Perttu Reijo Juhani Halme; J Antila; H Antila; H Aho; O Polo; H Salminiitty; E Toskala
Journal:  Eur Arch Otorhinolaryngol       Date:  2009-07-16       Impact factor: 2.503

Review 5.  Effects and side-effects of surgery for snoring and obstructive sleep apnea--a systematic review.

Authors:  Karl A Franklin; Heidi Anttila; Susanna Axelsson; Thorarinn Gislason; Paula Maasilta; Kurt I Myhre; Nina Rehnqvist
Journal:  Sleep       Date:  2009-01       Impact factor: 5.849

Review 6.  Surgical therapy of obstructive sleep apnea: a review.

Authors:  Bettina Carvalho; Jennifer Hsia; Robson Capasso
Journal:  Neurotherapeutics       Date:  2012-10       Impact factor: 7.620

7.  Reconstructive procedures for disturbed functions within the upper airway: pharyngeal breathing/snoring.

Authors:  Thomas Verse
Journal:  GMS Curr Top Otorhinolaryngol Head Neck Surg       Date:  2005-09-28

8.  Long-term results in obstructive sleep apnea syndrome (OSAS) after laser-assisted uvulopalatoplasty (LAUP).

Authors:  Önder Göktas; Mustafa Solmaz; Gökhan Göktas; Heidi Olze
Journal:  PLoS One       Date:  2014-06-30       Impact factor: 3.240

Review 9.  Reconsidering first-line treatment for obstructive sleep apnea: a systematic review of the literature.

Authors:  Brian W Rotenberg; Claudio Vicini; Edward B Pang; Kenny P Pang
Journal:  J Otolaryngol Head Neck Surg       Date:  2016-04-06
  9 in total

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