Treating obstructive sleep apnea with nasal operation and revised uvulopalatopharyngoplasty.
- Author:
Hai-Wen HU
1
;
Zhong GAN
;
Li-Hong LI
;
Li-Bing LIAO
;
Zeng-Bin GAO
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Female; Humans; Male; Middle Aged; Nose; surgery; Otorhinolaryngologic Surgical Procedures; methods; Palate, Soft; surgery; Pharynx; surgery; Sleep Apnea, Obstructive; surgery; Treatment Outcome; Uvula; surgery
- From: Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2007;42(2):95-99
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVENasal operation and/or H-uvulopalatopharyngoplasty (UPPP) was performed for obstructive sleep apnea hypopnea syndrome (OSAHS) patients with both oral pharynx and nasal obstruction, results analyzed.
METHODSPatients were divided into group A (46 cases) and group B (42 case) randomly. Nasal procedures were: septoplasty, radiofrequency reduction of inferior turbinate, adenoidectomy and functional endoscopic operation. Cases in group A had nasal operation first, while cases in group B first had UPPP. All patients had sleep study with polysomnography (PSG) 2 and 12 months after each operation. Those who failed to reach the criteria of being effective after first surgery (defined as a 25% reduction in baseline apnea hypopnea index (AHI) received second phase operation (nasal operation for group B and UPPP for group A). The response rates were compared between the two groups after each phase of operation.
RESULTSIn group A, the phase one operation were effective in 44.0% (11/25) for the mild degree OSAHS patients (defined as AHI < 20/h), according to the sleep study performed 2 months after surgery, and no recurrence after one-year. All moderate ones (defined as 20/h < AHI < 40/h) responded poorly to nasal operation. The overall response rate was 23.9% (11/46). Non-responses (35 cases) in group A underwent UPPP and the response rate to it was 85.7% (30/35) in one year. In group B, UPPP operation was effective in 63.6% (14/22) mild cases and 30.0% (6/20) moderate cases in 2 months but 4 cases had recurrence in one year. Twenty-two cases underwent the second phase operation of nose and the response rate was 86.4% (19/22) in one year. There was no statistical significance on the overall response rate between group A and B (89.1% vs 83.3%, P > 0.05). While there was statistical significance of response rate between those patients who had only one operation and those who had both surgeries (P < 0.05).
CONCLUSIONSThe combination of nasal procedures and UPPP is effective a for OSAHS patient with nasal diseases especially in mild and moderate cases.
