Palatal and tongue base surgery for surgical treatment of obstructive sleep apnea: a prospective study.

OBJECTIVE

To assess the effect of concurrent uvulopalatopharyngoplasty (UPPP) and hypopharyngeal procedures in obstructive sleep apnea (OSA) patients with diffuse airway narrowing.

STUDY DESIGN AND

SETTING

Forty-eight patients were treated surgically by a single surgeon in private practice over 2 years. Symptoms, Epworth score, and polysomnographic outcome were assessed preoperatively and postoperatively. The Friedman staging system was applied. UPPP with genioglossus advancement, hyoid suspension, or radiofrequency treatment was carried out.

RESULTS

In 37 patients with complete data, the average apnea-hypopnea index (AHI) was reduced from 46.5 +/- 24.8 to 14.9 +/- 16.8. The Epworth score was reduced from 12.1 +/- 4.9 to 6.7 +/- 3.7. Most patients reported improved sleep quality, alertness, memory, concentration, and mood.

CONCLUSION

Successful outcome, defined by symptom and AHI reduction, was achieved with multilevel surgery for most patients with advanced Friedman stages 2 and 3.

SIGNIFICANCE: Multilevel surgery seems effective in treating severe OSA patients with diffuse airway narrowing.

EBM RATING: C-4.