Mei Zhu1, Shusheng Gong2, Jingying Ye3, Yuyu Wang1, Xue Bai1, Kevin A Peng4. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Lu, Xicheng District, Beijing, 100050, China. 2. Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Lu, Xicheng District, Beijing, 100050, China. gongss@ccmu.edu.cn. 3. Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tsinghua Chang Gung Hospital, No. 168 Litang Road, Dongxiaokou Town, Changping District, Beijing, 102218, China. yejingying@yeah.net. 4. House Clinic and House Ear Institute, Los Angeles, CA, 90057, USA.
Abstract
BACKGROUND: Outcomes of surgical management of obstructive sleep apnea-hypopnea syndrome (OSAHS) can be difficult to predict preoperatively. AIMS/ OBJECTIVES: To study the effect of applying traction to the velum during drug-induced sleep endoscopy (DISE) in OSAHS patients, and to describe the use of traction velum in predicting surgical success. MATERIALS AND METHODS: 41 adult surgical patients with OSA (Friedman tongue position II and III) were evaluated by DISE. All patients subsequently underwent velopharyngeal surgery in the form of uvulopalatopharyngoplasty with tonsillectomy plus barbed reposition pharyngoplasty. RESULTS: Surgical responders (n = 26, 63.4%) and nonresponders (n = 15, 36.6%) demonstrated no significant differences with regard to preoperative AHI, age, sex, body mass index, and mean/lowest O2 saturation. Responders had a marked decrease in desaturation events (2.96 vs 0.03, p < 0.001) and percentage change in number of desaturation events before/after traction velum (56.7 vs 4.5, p < 0.001). Regression analysis revealed that reduction in mean desaturation events, with traction velum, by a percentage > 26.8% (odds ratio [OR] 1.046; 95% confidence interval [CI] 1.018-1.075; p = 0.001) was the only independent predictor of surgery success. CONCLUSIONS AND SIGNIFICANCE: OSAHS patients' velopharyngeal surgical outcome can be predicted by measuring the percentage change in the number of oxygen desaturation events before and after traction velum in DISE.
BACKGROUND: Outcomes of surgical management of obstructive sleep apnea-hypopnea syndrome (OSAHS) can be difficult to predict preoperatively. AIMS/ OBJECTIVES: To study the effect of applying traction to the velum during drug-induced sleep endoscopy (DISE) in OSAHS patients, and to describe the use of traction velum in predicting surgical success. MATERIALS AND METHODS: 41 adult surgical patients with OSA (Friedman tongue position II and III) were evaluated by DISE. All patients subsequently underwent velopharyngeal surgery in the form of uvulopalatopharyngoplasty with tonsillectomy plus barbed reposition pharyngoplasty. RESULTS: Surgical responders (n = 26, 63.4%) and nonresponders (n = 15, 36.6%) demonstrated no significant differences with regard to preoperative AHI, age, sex, body mass index, and mean/lowest O2 saturation. Responders had a marked decrease in desaturation events (2.96 vs 0.03, p < 0.001) and percentage change in number of desaturation events before/after traction velum (56.7 vs 4.5, p < 0.001). Regression analysis revealed that reduction in mean desaturation events, with traction velum, by a percentage > 26.8% (odds ratio [OR] 1.046; 95% confidence interval [CI] 1.018-1.075; p = 0.001) was the only independent predictor of surgery success. CONCLUSIONS AND SIGNIFICANCE: OSAHS patients' velopharyngeal surgical outcome can be predicted by measuring the percentage change in the number of oxygen desaturation events before and after traction velum in DISE.
Authors: Ulrich J Sommer; Clemens Heiser; Constanze Gahleitner; Raphael M Herr; Karl Hörmann; Joachim T Maurer; Boris A Stuck Journal: Dtsch Arztebl Int Date: 2016-01-11 Impact factor: 5.594