Outcomes of uvulopalatopharyngoplasty with harmonic scalpel after failure of continuous positive airway pressure in sleep apnea syndrome.

CONCLUSIONS

Our data highlight that uvulopalatopharyngoplasty (UPPP) with harmonic scalpel (HS) is a reliable treatment in selected patients affected by obstructive sleep apnea (OSA) and users of continuous positive airway pressure (CPAP).

OBJECTIVES

The aim of this paper was to verify the efficacy and applicability of UPPP with HS in the treatment of patients affected by OSA and users of CPAP.

METHODS

A total of 21 patients with a retropalatal obstruction and users of CPAP underwent UPPP with HS and were evaluated (before and 6 months after surgery) using the apnea/hypopnea index (AHI); oxygen desaturation index ≥4% (ODI(4)); Epworth Sleepiness Scale (ESS); snoring level (SL); subjective assessment of the postoperative pain on postoperative days 1, 3, and 10; and number of days until return to solid food.

RESULTS

Six months after surgery: AHI decreased significantly (p < 0.05) from 31.8 ± 2.83 to 9.0 ± 0.68; ODI(4) was 2.1 ± 0.4 vs a preoperative value of 24.0 ± 1.9; ESS scores were also significantly decreased (p < 0.05) from 14.0 ± 3.7 to 4.7 ± 2.2; SL was significantly lower (p < 0.05) 1.6 ± 0.3 vs 7.9 ± 0.8. Postoperatively, patients experienced lower levels of pain and the median of time to return to normal diet was 3 days.