STUDY OBJECTIVE: To evaluate and compare outcomes of uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea/hypopnea syndrome (OSAHS) using anatomy- and severity-based staging systems. DESIGN: Prospective design with a retrospective review. SETTING: A tertiary-care, sleep disorder referral center. PATIENTS: In total, 110 patients with OSAHS (105 men, 5 women; mean age, 43 years; apnea-hypopnea index, 44.4 +/- 28.8 events per hour; body mass index, 27.1 +/- 3.3 kg/m2). MEASUREMENTS: An anatomy-based staging system (stages I-IV) was used to classify patients with OSAHS by examining tongue-palate position, tonsil size, body mass index, and craniofacial deformities. Patients were also classified as having mild, moderate, moderate-severe, or severe OSAHS based on preoperative apnea-hypopnea index from polysomnography (a severity-based staging system). Surgical success was defined as a 50% or greater reduction in the apnea-hypopnea index and a postoperative apnea-hypopnea index of less than 20 events per hour. INTERVENTION: UPPP was performed in all patients. RESULTS: The overall success rate of UPPP was 78%. Success rates for mild (90%), moderate (73%), moderate-severe (81%), and severe (74%) diseases were similar (p = .10). Conversely, success rates for patients with anatomy-based stages I, II, III, and IV were 100%, 96%, 65%, and 20%, respectively; these rates were significantly different (p < .001). Changes in apnea-hypopnea index were significantly correlated with Friedman tongue position (FTP) (r = -0.33, p = .0004) and tonsil size (r = -0.37, p < .0001). The FTP (odds ratio = 0.43, SE = 0.13, p = .005, 95% confidence interval = 0.24-0.78) and tonsil size (odds ratio = 3.13, SE = 1.53, p = .02, 95% confidence interval = 1.20-8.17), but not the severity-based staging (odds ratio = 0.77, SE = 0.18, p = .283, 95% confidence interval = 0.49-1.23), were predictive of surgical success. CONCLUSION: The anatomy-based staging system predicted UPPP outcomes more effectively than did the severity-based staging. The anatomy-based staging system facilitates good case-selection information for counseling patients before UPPP surgery.
STUDY OBJECTIVE: To evaluate and compare outcomes of uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea/hypopnea syndrome (OSAHS) using anatomy- and severity-based staging systems. DESIGN: Prospective design with a retrospective review. SETTING: A tertiary-care, sleep disorder referral center. PATIENTS: In total, 110 patients with OSAHS (105 men, 5 women; mean age, 43 years; apnea-hypopnea index, 44.4 +/- 28.8 events per hour; body mass index, 27.1 +/- 3.3 kg/m2). MEASUREMENTS: An anatomy-based staging system (stages I-IV) was used to classify patients with OSAHS by examining tongue-palate position, tonsil size, body mass index, and craniofacial deformities. Patients were also classified as having mild, moderate, moderate-severe, or severe OSAHS based on preoperative apnea-hypopnea index from polysomnography (a severity-based staging system). Surgical success was defined as a 50% or greater reduction in the apnea-hypopnea index and a postoperative apnea-hypopnea index of less than 20 events per hour. INTERVENTION: UPPP was performed in all patients. RESULTS: The overall success rate of UPPP was 78%. Success rates for mild (90%), moderate (73%), moderate-severe (81%), and severe (74%) diseases were similar (p = .10). Conversely, success rates for patients with anatomy-based stages I, II, III, and IV were 100%, 96%, 65%, and 20%, respectively; these rates were significantly different (p < .001). Changes in apnea-hypopnea index were significantly correlated with Friedman tongue position (FTP) (r = -0.33, p = .0004) and tonsil size (r = -0.37, p < .0001). The FTP (odds ratio = 0.43, SE = 0.13, p = .005, 95% confidence interval = 0.24-0.78) and tonsil size (odds ratio = 3.13, SE = 1.53, p = .02, 95% confidence interval = 1.20-8.17), but not the severity-based staging (odds ratio = 0.77, SE = 0.18, p = .283, 95% confidence interval = 0.49-1.23), were predictive of surgical success. CONCLUSION: The anatomy-based staging system predicted UPPP outcomes more effectively than did the severity-based staging. The anatomy-based staging system facilitates good case-selection information for counseling patients before UPPP surgery.
Authors: Kenny Peter Pang; Guillermo Plaza; Peter M Baptista J; Carlos O'Connor Reina; Yiong Huak Chan; Kathleen A Pang; Edward B Pang; Cybil Mei Zhi Wang; Brian Rotenberg Journal: Eur Arch Otorhinolaryngol Date: 2018-05-25 Impact factor: 2.503
Authors: Kurt Tschopp; Thomas Zumbrunn; Christoph Knaus; Esther Thomaser; Thomas Fabbro Journal: Eur Arch Otorhinolaryngol Date: 2011-04-07 Impact factor: 2.503
Authors: Su Ru Liu; Hong Liang Yi; Shan Kai Yin; Jian Guan; Bin Chen; Li Li Meng; Kai Ming Su Journal: Eur Arch Otorhinolaryngol Date: 2013-02-27 Impact factor: 2.503