Ofer Jacobowitz1. 1. Columbia New York Presbyterian Department of Otolaryngology, New York, NY, USA. ofershel@hotmail.com
Abstract
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.
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.
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
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