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Comparison between short-term and long-term post-operative evaluation of sleep apnoea after uvulopalatopharyngoplasty

Published online by Cambridge University Press:  29 June 2007

Shao-Jung Lu ,
Shyue-Yih Chang  and
Guang-Ming Shiao
Shao-Jung Lu
Affiliation:
Departments of Otolaryngology, Veterans General Hospital, National Yang Ming Medical College, Taipei, Taiwan.
Shyue-Yih Chang*
Affiliation:
Departments of Otolaryngology, Veterans General Hospital, National Yang Ming Medical College, Taipei, Taiwan.
Guang-Ming Shiao
Affiliation:
Departments of Chest Medicine, Veterans General Hospital, National Yang Ming Medical College, Taipei, Taiwan.
*
Address for correspondence: Professor Shyue-Yih Chang, M.D., Department of Otolaryngology. National Yang Ming Medical College. Veterans General Hospital, Taipei, Taiwan. Fax: 011-886-2-8757331
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Abstract

For a long time uvulopalatopharyngoplasty (UPPP) has been used to treat the obstructive sleep apnoea syndrome (OSAS). The diverse surgical effects, the inadequate understanding of operation effect consistency, the possibility of disease progression, and the few reported papers for long-term evaluation after UPPP aroused our interest in designing this study. Fifteen OSAS patients who had undergone UPPP with pre-operative, initial post-operative and long-term post-operative polysomnographic studies were included in this study. Long-term post-operative polysomnography was undertaken more than five years after surgery. The polysomnographic evaluations included respiratory disturbance index (RD I), duration of saturation SaO2 <85 per cent (DOS), and the lowest O2 saturation (LOS). Amongst them, 10 patients with initial post-operative RDI reduction > 50 per cent were considered responders. In these responders, the long-term follow-up results of all three parameters showed improvement compared to the preoperative data. In a comparison between the initial and long-term post-operative sleep study results, LOS and DOS showed no significant difference. However, the long-term post-operative RDI result became significantly worse. More than 80 per cent of all cases had subjective symptomatic improvement in the long-term post-operative evaluation. The subjective improvement after operation is not adequately correlated to the polysomnographic result. We suggest that long-term follow-up for patients after UPPP is necessary.

Keywords

Sleep apnoea syndromesUvulasurgery
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 4 , April 1995 , pp. 308 - 312
Copyright
Copyright © JLO (1984) Limited 1995

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References

Anand, V., Ferguson, P., Schoen, L. (1991) Obstructive sleep apnea: a comparison of continuous positive airway pressure and surgical treatment. Otolaryngology – Head and Neck Surgery 105: 383–390.CrossRefGoogle ScholarPubMed
Blakley, B. W., Maisel, R. H., Mahowald, M. (1986) Sleep parameters afer surgery for obstructive sleep apnea. Otolaryngology – Head and Neck Surgery 95: 23–28.CrossRefGoogle Scholar
Caldarelli, K. K., Cartwright, R., Lilie, J. K. (1986) Severity of sleep apnea as a predictor of successful treatment by palatopharyngoplasty. Laryngoscope 99: 667–680.Google Scholar
Chen, F. J., Chang, S. Y. (1991) Effects of uvulopalatopharyngoplasty in obstructive sleep apnea syndrome. Chinese Medical Journal (Taipei) 47: 176–180.Google ScholarPubMed
Croft, C. B., Pringle, M. (1991) Sleep nasendoscopy: a technique of assessment in snoring and obtsructive sleep apnoea. Clinical Otolaryngology and Allied Science 16: 504–509.CrossRefGoogle ScholarPubMed
Dickson, R. I., Blokmanis, A. (1987) Treatment of obstructive sleep apnea by uvulopalatopharyngoplasty. Laryngoscope 97: 1054–1059.CrossRefGoogle ScholarPubMed
Findley, L. J., Barth, J. T., Powers, D. C. (1986) Cognitive impairment in patients with obstructive sleep apnea and associated hypoxemia. Chest 909: 686–689.CrossRefGoogle Scholar
Findley, L. J., Unverzagt, M. E., Suratt, P. M. (1988) Automobile accidents involving patients with obstructive sleep apnea. American Review of Respiratory Disease 139: 337–340.CrossRefGoogle Scholar
Fujita, S., Conway, W., Zorick, F. J., Roth, T. (1981) Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngology – Head and Neck Surgery 89: 923–934.CrossRefGoogle Scholar
Fujita, S., Conway, W., Zorick, F. J. (1985) Evaluation of the effectiveness of uvulopalatopharyngoplasty. Laryngoscope 95: 70–74.Google ScholarPubMed
Fujita, S. (1984) UPPP for sleep apnea and snoring. Ear, Nose and Throat Journal 63: 227–235.Google ScholarPubMed
Gislason, T., Lindholm, C. E., Almqvist, M. (1988) Uvulopalatopharyngoplasty in the sleep apnea syndrome. Archives of Otolaryngology – Head and Neck Surgery 114: 45–51.CrossRefGoogle ScholarPubMed
Guilleminault, C., Connolly, S., Winkle, R. (1983) Cardiac arrhythmia and conduction disturbance during sleep in 400 patients wth sleep apnea syndrome. American Journal of Cardiology 52: 490–494.CrossRefGoogle Scholar
Guilleminault, C. (1983) Natural history, cardiac impact, and long-term follow-up of sleep apnea syndrome. In Long-term Evaluation and Natural History of Sleep Disorders. (Guilleminault, C., Lugaresi, E., eds.), Raven Press. New York. pp 107–125.Google Scholar
He, J., Kryger, M., Zorick, F.Conway, W., Roth, T. (1988) Mortality and apnea index in obstructive sleep apnea. Chest 94: 9–14.CrossRefGoogle ScholarPubMed
Katsantonis, G. P., Maas, C. S., Walsh, J. K. (1989) The predictive efficacy of the Muller maneuver in uvulopalatopharyngoplasty. Laryngoscope 99: 667–680.CrossRefGoogle ScholarPubMed
Katsanton, G. P., Walsh, J. K., Schweitzer, P. K., Friedman, W. H. (1985) Further evaluation of uvulopalatopharyngoplasty in the treatment of obstructive sleep apnea syndrome. Otolaryngology – Head and Neck Surgery 93: 244–250.CrossRefGoogle Scholar
Maisel, R. H., Antonelli, P. J., Iber, C., Mahowald, M., Wilson, K. S., Fiedler, B., Schluter, J. (1992) Uvulopalatopharyngoplasty for obstructive sleep apnea: a community's experience. Laryngoscope 102: 604–607.CrossRefGoogle ScholarPubMed
Partinen, M., Jamieson, A., Guilleminault, C. (1988) Long-term outcome for obstructive sleep apnea syndrome patients: mortality. Chest 94: 1200–1204.CrossRefGoogle ScholarPubMed
Remmers, J. C., De Groot, W. J., Sauerland, E. K., Arch, A. M. (1978) Pathogenesis of upper airway occlusion during sleep. Journal of Applied Physiology 44: 931–938.CrossRefGoogle ScholarPubMed
Riley, R., Powell, N., Guilleminault, C. (1993) Obstructive sleep apnea syndrome: a surgical protocol for dynamic upper airway reconstruction. Journal of Oral and Maxillofacial Surgery 51: 742–747.CrossRefGoogle ScholarPubMed
Simmons, F B., Guilleminault, C., Miles, L. (1984) The palatopharyngoplasty operation for snoring and sleep apnea: an interim report. Otolaryngology – Head and Neck Surgery 4: 375.CrossRefGoogle Scholar
Sullivan, C., Issa, F., Berthon-Jones, M. (1981) Reversal of obstructive sleep apnea by continuous positive airway pressure applied through the nares. Lancet 2: 862–865.CrossRefGoogle Scholar
Wetmore, S., Scrima, L., Synderman, N. L. (1986) Postoperative evaluation of sleep apnea after uvulopalatophar yngoplasty. Laryngoscopy 96: 738–741.CrossRefGoogle Scholar