[Analysis of the difference of therapeutic effect and predictive factors between postural and non-postural OSA after modified uvulopalatopharyngoplasty].

Objective

To analyze the factors influencing the outcome of uvulopalatopharyngoplasty in positional obstructive sleep apnea（POSA） and non-positional OSA（NPOSA） patients, and to explore the differences between the two groups.

Methods

The data of 101 patients with obstructive sleep apnea who received treatment from November 2020 to November 2023 were retrospectively analyzed. Among them, 45 positional patients（POSA group） and 56 non-positional patients（NPOSA group）, who underwent overnight polysomnography were included. The upper airway（UA） anatomy was evaluated by three-dimensional computer tomography（3D-CT）. All patients received revised uvulopalatopharyngoplasty with uvula preservation and were followed using polysomnography for at least three months postoperatively.

Results

The overall effective rate was 55.45%. The surgical success rate in POSA undergoing UPPP was higher than NPOSA（POSA 30/45, 66.7% versus NPOSA 26/56, 46.4%, P=0.042）. The H-UPPP effect of POSA was negatively correlated with the minimum lateral airway of the Velopharyngeal airway（r=-0.505, P<0.001）, the minimum lateral airway of the glossopharyngeal airway（r=-0.474, P=0.001） and the minimum cross-sectional area（r=-0.394, P=0.007）. Logistic analysis showed that minimal lateral airway of the glossopharynxgeum（mLAT）（OR 0.873; 95%CI 0.798-0.955, P=0.003） was a significant predictor for surgical outcomes among POSA patients. In NPOSA, age（OR 0.936; 95%CI 0.879-0.998, P=0.042） was a significant predictor for surgical outcomes.

Conclusion

The effect of H-UPPP was higher in POSA than in NPOSA. The width of glossopharyngeal mLAT was an important predictor of POSA efficacy. Age was a predictor of NPOSA efficacy.