OBJECTIVE: To examine the effect of positional dependency on surgical success among patients with severe obstructive sleep apnea (OSA) following modified uvulopalatopharyngoplasty, known as relocation pharyngoplasty. STUDY DESIGN: Case series with planned data collection. SETTING: Tertiary referred center. SUBJECTS AND METHODS: Standard nocturnal polysomnography was used to compare the apnea-hypopnea index (AHI) in different sleep positions before and after relocation pharyngoplasty in 47 consecutive patients with severe OSA (AHI, 59.5 ± 18.2 events/hour; Epworth Sleepiness Scale [ESS] scores, 12.2 ± 4.4) who failed continuous positive airway pressure therapy. Positional (dependency) OSA was defined when the supine:non-supine AHI ratio was >2, otherwise it was defined as nonpositional OSA. Surgical success was defined as a ≥50% reduction in AHI and a postoperative AHI of ≤20 events/hour. Polysomnographic parameters, ESS, and surgical success following surgery were recorded. RESULTS: Of the 47 patients, 27 (57%) had positional OSA and 20 (43%) nonpositional OSA. The nonpositional OSA patients had higher AHI and ESS scores than the positional OSA patients (P = .002 and .104, respectively). Relocation pharyngoplasty significantly improved AHI and ESS scores in both positional and nonpositional OSA groups 6 months postoperatively (P < .05). The overall surgical success rate was 49%; however, positional OSA patients had a significantly higher success rate than nonpositional OSA patients (67% vs 25%, P = .008). CONCLUSION: The presence of positional dependency at baseline was a favorable outcome predictor of surgical success among severe OSA patients undergoing relocation pharyngoplasty.
OBJECTIVE: To examine the effect of positional dependency on surgical success among patients with severe obstructive sleep apnea (OSA) following modified uvulopalatopharyngoplasty, known as relocation pharyngoplasty. STUDY DESIGN: Case series with planned data collection. SETTING: Tertiary referred center. SUBJECTS AND METHODS: Standard nocturnal polysomnography was used to compare the apnea-hypopnea index (AHI) in different sleep positions before and after relocation pharyngoplasty in 47 consecutive patients with severe OSA (AHI, 59.5 ± 18.2 events/hour; Epworth Sleepiness Scale [ESS] scores, 12.2 ± 4.4) who failed continuous positive airway pressure therapy. Positional (dependency) OSA was defined when the supine:non-supine AHI ratio was >2, otherwise it was defined as nonpositional OSA. Surgical success was defined as a ≥50% reduction in AHI and a postoperative AHI of ≤20 events/hour. Polysomnographic parameters, ESS, and surgical success following surgery were recorded. RESULTS: Of the 47 patients, 27 (57%) had positional OSA and 20 (43%) nonpositional OSA. The nonpositional OSA patients had higher AHI and ESS scores than the positional OSA patients (P = .002 and .104, respectively). Relocation pharyngoplasty significantly improved AHI and ESS scores in both positional and nonpositional OSA groups 6 months postoperatively (P < .05). The overall surgical success rate was 49%; however, positional OSA patients had a significantly higher success rate than nonpositional OSA patients (67% vs 25%, P = .008). CONCLUSION: The presence of positional dependency at baseline was a favorable outcome predictor of surgical success among severe OSA patients undergoing relocation pharyngoplasty.
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: Sherif M Askar; Mohamed E Abd El-Bary; Mohammad E Elshora; Ahmed F Al Gohary; Ameer A Abosharkh; Alaa Omar Khazbak Journal: Eur Arch Otorhinolaryngol Date: 2022-01-31 Impact factor: 2.503
Authors: Maria V Suurna; Ofer Jacobowitz; Jolie Chang; Ioannis Koutsourelakis; David Smith; Uri Alkan; Mark D'Agostino; Maurits Boon; Clemens Heiser; Paul Hoff; Colin Huntley; David Kent; Alan Kominsky; Richard Lewis; Joachim T Maurer; Madeline J Ravesloot; Ryan Soose; Armin Steffen; Edward M Weaver; Amy M Williams; Tucker Woodson; Kathleen Yaremchuk; Stacey L Ishman Journal: J Clin Sleep Med Date: 2021-12-01 Impact factor: 4.062
Authors: David Kent; Jeffrey Stanley; R Nisha Aurora; Corinna G Levine; Daniel J Gottlieb; Matthew D Spann; Carlos A Torre; Katherine Green; Christopher G Harrod Journal: J Clin Sleep Med Date: 2021-12-01 Impact factor: 4.062