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Associated predictors of therapeutic response to uvulopharyngopalatoplasty for severe obstructive sleep apnea hypopnea syndrome

  • Laryngology
  • Published:
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Abstract

The aim of this study was to determine the associated factors affecting the outcome of uvulopharyngopalatoplasty (UPPP) in patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS), and to investigate whether cephalometric measurements were predictive of the therapeutic response to UPPP in patients with severe OSAHS. We retrospectively studied 51 consecutive patients who underwent revised UPPP with uvula preservation (H-UPPP), or Z-palatopharyngoplasty (ZPPP) for severe OSAHS [apnea–hypopnea index (AHI) >30]. All patients were evaluated using physical examination, Epworth Sleepiness Scale (ESS), cephalometry, and nocturnal polysomnography (PSG) before surgery and at 6–12 months after surgery. Based on the success criteria defined as an AHI of <20 and a decrease >50 %, the overall success rate was 45.1 %. The preoperative distance from the posterior border of the uvula to the middle pharyngeal wall (U-MPW) was significantly longer in the responder group than in the nonresponder group, when considering the whole group or the H-UPPP group alone. Among all study subjects, U-MPW and change in body mass index (△BMI) were the significant predictors of surgical success. U-MPW was the key predictor for H-UPPP surgical success, whereas mandibular plane angle (MPA) and Friedman stage were the key predictors for ZPPP surgical success. In conclusion, U-MPW was a significant predictor of UPPP surgical success. Patients with U-MPW >10 mm who are unwilling to receive nasal continuous positive airway pressure (CPAP) therapy might be suitable candidates for UPPP surgery.

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Acknowledgments

Source of funding: program for advancing front technology of Shanghai Shenkan Center (SHDC12010209).

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Affiliated Sixth People’s Hospital of Shang Hai Jiao Tong University, Yishan Road 600, Shanghai, China

    Su Ru Liu, Hong Liang Yi, Shan Kai Yin, Jian Guan, Bin Chen, Li Li Meng & Kai Ming Su

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  1. Su Ru Liu
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  2. Hong Liang Yi
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  3. Shan Kai Yin
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  4. Jian Guan
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  5. Bin Chen
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  6. Li Li Meng
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  7. Kai Ming Su
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Correspondence to Hong Liang Yi or Kai Ming Su.

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Liu, S.R., Yi, H.L., Yin, S.K. et al. Associated predictors of therapeutic response to uvulopharyngopalatoplasty for severe obstructive sleep apnea hypopnea syndrome. Eur Arch Otorhinolaryngol 270, 1411–1417 (2013). https://doi.org/10.1007/s00405-013-2404-5

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  • DOI: https://doi.org/10.1007/s00405-013-2404-5

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