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The potential effects of obesity on predicting outcomes of velopharyngeal surgery for obstructive sleep apnea

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To explore the outcome associated factors of velopharyngeal surgery for treating obstructive sleep apnea (OSA) and the effects of obesity.

Methods

A total of 175 adult OSA patients who underwent velopharyngeal surgery, including the revised uvulopalatopharyngoplasty with uvula preservation (H-UPPP) alone or the combination of H-UPPP and transpalatal advancement pharyngoplasty, were retrospectively studied. The pre-operative information of these patients, including physical examination, polysomnography (PSG), and upper airway CT, were collected for analysis. Post-operative PSG used for evaluation of surgical outcomes were all done 3–6 months after surgery.

Results

The overall AHI decreased significantly from 59.7 ± 18.8 events/h to 22.1 ± 18.8 events/h after surgery (P < 0.001), and there were 104 responders (59.4%). Tonsil size, the percentage of time with oxygen saturation below 90% (CT90), the vertical distance between the lower margin of the mandible and the lower margin of the hyoid (MH), and surgical methods were independently associated with treatment outcomes. The independent associated factors for surgical success were large tonsil size and combined surgical methods in non-obese patients (BMI < 27.5 kg/m2) and were large tonsil size, short MH, and low CT90 in obese patients (BMI ≥ 27.5 kg/m2), respectively.

Conclusions

Although BMI is not directly associated with surgical outcomes of velopharyngeal procedures, the outcomes associated factors in obese and non-obese OSA patients were not entirely the same. Obesity should be taken into accounts in pre-operative patient selection of such surgery.

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Availability of data and materials

All authors had access to the final study data and material.

Code availability

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Acknowledgements

We gratefully acknowledge all the medical staff who had involved in this study.

Funding

This study was supported by Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (XMLX201703) and Natural Science Foundation of Beijing Municipality (7204315).

Author information

Author notes

  1. Junbo Zhang and Jingjing Li have contributed equally to this work.

Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China

    Junbo Zhang

  2. Department of Otolaryngology, Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Litang Road 168#, Changping District, Beijing, 102218, China

    Jingjing Li, Guoping Yin, Xin Cao & Jingying Ye

Authors
  1. Junbo Zhang
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  2. Jingjing Li
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  3. Guoping Yin
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  4. Xin Cao
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  5. Jingying Ye
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Contributions

ZJ and YJ contributed to the study conception and design. YJ supervised this research. ZJ, LJ, and CX contributed to the material preparation and data collection. ZJ, LJ, YG, and YJ contributed to the analysis and interpretation of data. ZJ and LJ wrote the first draft of the manuscript. YG and YJ made critical revision for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jingying Ye.

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All authors declare that they have no conflict of interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All authors reviewed and approved the final manuscript.

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Zhang, J., Li, J., Yin, G. et al. The potential effects of obesity on predicting outcomes of velopharyngeal surgery for obstructive sleep apnea. Eur Arch Otorhinolaryngol 279, 1951–1956 (2022). https://doi.org/10.1007/s00405-021-07175-9

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  • DOI: https://doi.org/10.1007/s00405-021-07175-9

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