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Effect of uvulopalatopharyngoplasty on retropalatal region

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Abstract

Flexible optic laryngoscopy (FOL) allows us to visualize the obstructive sleep apnea (OSA)-related airway passages. Retropalatal region is a part of upper airway contributing to the OSA. We aimed to demonstrate the changes in the retropalatal surface area (RPSA) after submucosal uvulopalatopharyngoplasty (smUPPP) in an attempt to exhibit enlargement as a predictor of surgical treatment. It is a prospective, case–control study and conducted at the Otolaryngology department in a university hospital. Twenty patients with OSA who underwent smUPPP were prospectively evaluated. Pre and postoperative respiratory disturbance index (RDI) and RPSA measurements were studied. Retropalatal region videos were obtained at the base of uvula during FOL. Photographic images were captured at the same level of a virtual horizontal line passing through the base of uvula posteriorly to measure RPSAs using AutoCad2004. RDI levels, RPSA measurements were compared using paired t test. Twenty patients underwent smUPPP. There were 17 (85 %) male and 3 (15 %) female. The mean age was 37 years. The RPSA measurements were between 18.41 and 144.102 (mean 63.39) preoperatively. The RPSA measurements were between 83.784 and 255.463 (mean 143.87) postoperatively. The RPSA measurements were significantly enlarged postoperatively (p < 0.0005). The mean RPSA increased from 63.39 ± 29.3 to 143.82 ± 57.8. The mean RDI decreased from 22.95 ± 19.2 to 9.0 ± 8.2 (p = 0.011). RPSA increases in smUPPP patients postoperatively, evidencing enlarged retropalatal region. Decreased RDI levels indicate amelioration in OSA. RPSA measurements can be used to predict UPPP surgical treatment success.

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References

  1. Woodson BT, Wooten MR (1994) Manometric and endoscopic localization of airway obstruction after uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 111:38–43

    PubMed  CAS  Google Scholar 

  2. Friedman M, Schalch P (2007) Surgery of the palate and oropharynx. Otolaryngol Clin North Am 40(4):829–843

    Article  PubMed  Google Scholar 

  3. Fujita S, Conway W, Zorick F et al (1981) Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 89:923–934

    PubMed  CAS  Google Scholar 

  4. Friedman M, Landsberg R, Tanyeri H (2000) Submucosal uvulopalatopharyngoplasty. Op Tech Otolaryngol Head Neck Surg 11:26–29

    Article  Google Scholar 

  5. Friedman M, Ibrahim HZ, Vidyasagar R et al (2004) Z-palatoplasty (ZPP): a technique for patients without tonsils. Otolaryngol Head Neck Surg 131:89–100

    Article  PubMed  Google Scholar 

  6. Friedman M, Ibrahim H, Lowenthal S, Ramakrishnan V, Joseph NJ (2004) Uvulopalatoplasty (UP2): a modified technique for selected patients. Laryngoscope 114(3):441–449

    Article  PubMed  Google Scholar 

  7. Neruntarat C (2003) Uvulopalatal flap for snoring on an outpatient basis. Otolaryngol Head Neck Surg 129(4):353–359

    Article  PubMed  Google Scholar 

  8. Friedman M, Ibrahim H, Joseph N (2004) Staging of obstructive sleep apnea/hypopnea syndrome: a guide to appropriate treatment. Laryngoscope 114:454–459

    Article  PubMed  Google Scholar 

  9. Friedman M, Vidyasagar R, Bliznikas D et al (2005) Does severity of obstructive sleep apnea/hypopnea syndrome predict uvulopalatopharyngoplasty outcome? Laryngoscope 115:2109–2113

    Article  PubMed  Google Scholar 

  10. Thakkar K, Yao M (2007) Diagnostic studies in obstructive sleep apnea. Otolaryngol Clin North Am 40(4):785–805

    Article  PubMed  Google Scholar 

  11. Sher AE, Thorpy MJ, Shprintzen RJ, Spielman AJ, Burack B, McGregor PA (1985) Predictive value of Müller maneuver in selection of patients for uvulopalatopharyngoplasty. Laryngoscope. 95(12):1483–1487

    Article  PubMed  CAS  Google Scholar 

  12. Ritter CT, Trudo FJ, Goldberg AN, Welch KC, Maislin G, Schwab RJ (1999) Quantitative evaluation of the upper airway during nasopharyngoscopy with the Müller maneuver. Laryngoscope. 109(6):954–963

    Article  PubMed  CAS  Google Scholar 

  13. Hsu PP, Han HN, Chan YH, Tay HN, Brett RH, Lu PK, Blair RL (2004) Quantitative computer-assisted digital-imaging upper airway analysis for obstructive sleep apnoea. Clin Otolaryngol Allied Sci 29(5):522–529

    Article  PubMed  CAS  Google Scholar 

  14. Ko MT, Su CY (2008) Computer-assisted quantitative evaluation of obstructive sleep apnea using digitalized endoscopic imaging with Muller maneuver. Laryngoscope. 118(5):909–914

    Article  PubMed  Google Scholar 

  15. Woodson BT (2000) Transpalatal advancement pharyngoplasty for obstructive sleep apnea. Op Tech Otolaryngol Head Neck Surg 11:36–40

    Article  Google Scholar 

  16. Kezirian EJ, Goldberg AN (2006) Hypopharyngeal surgery in obstructive sleep apnea: an evidence-based medicine review. Arch Otolaryngol Head Neck Surg 132(2):206–213

    Article  PubMed  Google Scholar 

  17. Friedman M, Tanyeri H, La Rosa M et al (1999) Clinical predictors of obstructive sleep apnea. Laryngoscope 109:1901–1907

    Article  PubMed  CAS  Google Scholar 

  18. Woodson BT (2010) Pharyngeal upper airway (phuaw) structural assessment in OSA. Otolaryngol Head Neck Surg. 143:2S2

    Article  Google Scholar 

  19. Hsu PP, Tan AK, Tan BY, Gan EC, Chan YH, Blair RL, Lu PK (2007) Uvulopalatopharyngoplasty outcome assessment with quantitative computer-assisted videoendoscopic airway analysis. Acta Otolaryngol 127(1):65–70

    Article  PubMed  Google Scholar 

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Correspondence to Gediz Murat Serin.

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Tanyeri, H., Serin, G.M., Ayanoglu Aksoy, E. et al. Effect of uvulopalatopharyngoplasty on retropalatal region. Eur Arch Otorhinolaryngol 270, 1161–1165 (2013). https://doi.org/10.1007/s00405-012-2250-x

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  • DOI: https://doi.org/10.1007/s00405-012-2250-x

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