One-stage laser-assisted uvulopalatoplasty.

OBJECTIVE

To assess the efficacy of an author-modified LAUP technique using the principles of UPPP surgery. This new one-stage method of LAUP is described in detail.

DESIGN

A retrospective review of all one-stage LAUPs performed.

SETTING

The Division of Otolaryngology, University of British Columbia, Vancouver, BC.

METHOD: This one-stage LAUP was performed on all patients.

MAIN OUTCOME MEASURES: Improvement of snoring, postoperative pain, polysomnography, home oximetry, the Respiratory Disturbance Index, and the need for a second treatment.

RESULTS

Two hundred twenty patients have undergone this more aggressive excisional approach, and only 10 needed a second treatment. A 75 to 100% improvement in snoring was noted by 83% of cases. In patients with some residual noise, 78% described only heavy breathing when lying on their back. Postoperative pain was mild (7 days) to moderate (7-10 days) in 79% of cases. Eighty-three percent of patients missed no work after treatment. Documented sleep-apnea was present in 74 people (33%), and 96% of these reported a more restful sleep with less daytime fatigue postoperatively. Ten of 14 patients (71%) with postoperative sleep studies had apneas eliminated or reduced by more than 50%. Overall patient satisfaction was 97%. A low-level laser from Europe (LLLT) has been introduced as an adjunct to help control postoperative pain. A clinical trial on its use in UPPP surgery is also described.