Yen-Ting Lu1,2,3, Shyh-Kuan Tai4,5, Tsung-Lun Lee6,7. 1. Department of Otolaryngology, St. Martin De Porres Hospital, Chiayi, Taiwan, Republic of China. 2. Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China. 3. School of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China. 4. Department of Otolaryngology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd, Beitou District, Taipei, 11217, Taiwan, Republic of China. 5. Department of Otolaryngology, National Yang Ming University, Taipei, Taiwan, Republic of China. 6. Department of Otolaryngology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd, Beitou District, Taipei, 11217, Taiwan, Republic of China. cllee1210@gmail.com. 7. Department of Otolaryngology, National Yang Ming University, Taipei, Taiwan, Republic of China. cllee1210@gmail.com.
Abstract
BACKGROUNDS: The aim of this study is to introduce pterygomandibular suspension suture as a simple modification of uvulopalatopharyngoplasty for severe obstructive sleep apnea in dealing with lateral pharyngeal wall and retropalatal space collapse. METHODS: This retrospective study was conducted at Taipei Veterans General Hospital, Taiwan. Ten adult patients underwent modified uvulopalatopharyngoplasty with pterygomandibular suspension suture according to following inclusion criteria: severe obstructive sleep apnea (apnea-hypopnea index [AHI] > 30 events/h), type I Fujita with lateral pharyngeal wall collapse, and failure for continuous positive airway pressure (CPAP) therapy. The philosophy of this modification technique is to create a firm anterolateral suspension of the lateral pharyngeal wall and soft palate by sutures. RESULTS: The mean operative time of modified uvulopalatopharyngoplasty with pterygomandibular suspension suture was 60 min. The mean AHI decreased significantly from 77.2 ± 25.0 preoperatively to 28.7 ± 18.8 postoperatively (P = 0.005) and the lowest oxygen saturation increased from 69.9 ± 11.4 to 81.1 ± 7.19% (P = 0.005). No major perioperative complication such as massive bleeding or respiratory distress was noted. No patient experienced a swallowing disturbance, taste change, or voice change 6 months postoperatively. The mean period for resuming a normal diet was 15 days. CONCLUSION: Modified uvulopalatopharyngoplasty with pterygomandibular suspension suture is a simplified and effective surgical approach with satisfactory functional recovery for selective patients with severe obstructive sleep apnea.
BACKGROUNDS: The aim of this study is to introduce pterygomandibular suspension suture as a simple modification of uvulopalatopharyngoplasty for severe obstructive sleep apnea in dealing with lateral pharyngeal wall and retropalatal space collapse. METHODS: This retrospective study was conducted at Taipei Veterans General Hospital, Taiwan. Ten adult patients underwent modified uvulopalatopharyngoplasty with pterygomandibular suspension suture according to following inclusion criteria: severe obstructive sleep apnea (apnea-hypopnea index [AHI] > 30 events/h), type I Fujita with lateral pharyngeal wall collapse, and failure for continuous positive airway pressure (CPAP) therapy. The philosophy of this modification technique is to create a firm anterolateral suspension of the lateral pharyngeal wall and soft palate by sutures. RESULTS: The mean operative time of modified uvulopalatopharyngoplasty with pterygomandibular suspension suture was 60 min. The mean AHI decreased significantly from 77.2 ± 25.0 preoperatively to 28.7 ± 18.8 postoperatively (P = 0.005) and the lowest oxygen saturation increased from 69.9 ± 11.4 to 81.1 ± 7.19% (P = 0.005). No major perioperative complication such as massive bleeding or respiratory distress was noted. No patient experienced a swallowing disturbance, taste change, or voice change 6 months postoperatively. The mean period for resuming a normal diet was 15 days. CONCLUSION: Modified uvulopalatopharyngoplasty with pterygomandibular suspension suture is a simplified and effective surgical approach with satisfactory functional recovery for selective patients with severe obstructive sleep apnea.
Authors: Wietske Richard; Jantine Venker; Cindy den Herder; Dennis Kox; Bob van den Berg; Martin Laman; Harm van Tinteren; Nico de Vries Journal: Eur Arch Otorhinolaryngol Date: 2007-04-19 Impact factor: 2.503
Authors: Adriano Braga; Luiz H Carboni; Tassiana do Lago; Daniel S Küpper; Alan Eckeli; Fabiana C P Valera Journal: Eur Arch Otorhinolaryngol Date: 2012-05-13 Impact factor: 2.503