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Predicting outcome of velopharyngeal surgery in drug-induced sleep endoscopy by traction velum

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Abstract

Background

Outcomes of surgical management of obstructive sleep apnea–hypopnea syndrome (OSAHS) can be difficult to predict preoperatively.

Aims/objectives

To study the effect of applying traction to the velum during drug-induced sleep endoscopy (DISE) in OSAHS patients, and to describe the use of traction velum in predicting surgical success.

Materials and methods

41 adult surgical patients with OSA (Friedman tongue position II and III) were evaluated by DISE. All patients subsequently underwent velopharyngeal surgery in the form of uvulopalatopharyngoplasty with tonsillectomy plus barbed reposition pharyngoplasty.

Results

Surgical responders (n = 26, 63.4%) and nonresponders (n = 15, 36.6%) demonstrated no significant differences with regard to preoperative AHI, age, sex, body mass index, and mean/lowest O2 saturation. Responders had a marked decrease in desaturation events (2.96 vs 0.03, p < 0.001) and percentage change in number of desaturation events before/after traction velum (56.7 vs 4.5, p < 0.001). Regression analysis revealed that reduction in mean desaturation events, with traction velum, by a percentage > 26.8% (odds ratio [OR] 1.046; 95% confidence interval [CI] 1.018–1.075; p = 0.001) was the only independent predictor of surgery success.

Conclusions and significance

OSAHS patients’ velopharyngeal surgical outcome can be predicted by measuring the percentage change in the number of oxygen desaturation events before and after traction velum in DISE.

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Authors and Affiliations

  1. Department of Otorhinolaryngology—Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Lu, Xicheng District, Beijing, 100050, China

    Mei Zhu, Shusheng Gong, Yuyu Wang & Xue Bai

  2. Department of Otorhinolaryngology—Head and Neck Surgery, Beijing Tsinghua Chang Gung Hospital, No. 168 Litang Road, Dongxiaokou Town, Changping District, Beijing, 102218, China

    Jingying Ye

  3. House Clinic and House Ear Institute, Los Angeles, CA, 90057, USA

    Kevin A. Peng

Authors
  1. Mei Zhu
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  2. Shusheng Gong
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  3. Jingying Ye
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  4. Yuyu Wang
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  5. Xue Bai
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  6. Kevin A. Peng
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Correspondence to Shusheng Gong or Jingying Ye.

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Zhu, M., Gong, S., Ye, J. et al. Predicting outcome of velopharyngeal surgery in drug-induced sleep endoscopy by traction velum. Eur Arch Otorhinolaryngol 278, 821–826 (2021). https://doi.org/10.1007/s00405-020-06292-1

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  • DOI: https://doi.org/10.1007/s00405-020-06292-1

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