Long-term results of palatal implantation for severe obstructive sleep apnea patients with prominent retropalatal collapse.

BACKGROUND

Most previous reports on palatal implantation for patients with severe obstructive sleep apnea have been anecdotal. Our objective in this study was to assess the long-term outcomes of palatal implantations from objective as well as subjective perspectives when applied to patients with severe obstructive sleep apnea and prominent retropalatal collapse.

METHODS

This retrospective review was conducted in a single institution using subjective data (Epworth Sleepiness Scale and visual analog scales of snoring sounds and sleep quality) and objective data (respiratory disturbance index, minimum O2 saturation, sleep efficiency, and snoring index using a polysomnograph) before and after surgery. A total of ten patients were enrolled in this study. The median time between pre-operative sleep-related tests and the operation date was 1.0 months and the median time between operation date and post-operative sleep-related tests was 33.0 months.

RESULTS

Significant improvements were observed in the visual analog scale scores of snoring (p = 0.004), visual analog scale scores of sleep quality (p = 0.005), and Epworth Sleepiness Scale (p = 0.012). Eight of the ten patients reported a reduction of at least 50% on the visual analog scale of snoring sounds, which was the criterion of subjective surgical success. We also observed significant improvements in the respiratory disturbance index (p = 0.009) and minimum O2 saturation (p = 0.033). Two of the ten patients presented a reduction in respiratory disturbance index of ≥50% and a subsequent respiratory disturbance index of <20, which were the criteria of objective surgical success. A percentage change in respiratory disturbance index was negatively associated with prominent retrolingual collapse and the length of the soft palate.

CONCLUSION

Patients with severe obstructive sleep apnea and prominent retropalatal collapse may benefit from palatal implantation from a subjective perspective. Palatal implantation could be considered an alternate form of treatment for some cases of severe obstructive sleep apnea, due to the likelihood of improvement in clinical symptoms and the normalization of sleep quality.