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The Effect of Uvulopalatopharyngoplasty with Tonsillectomy in Patients with Obstructive Sleep Apnea

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Abstract

In the current study, we evaluated the effectiveness of uvulopalatopharyngoplasty (UPPP) in treatment of patients with obstructive sleep apnea (OSA) syndrome. All patients were previously received medical treatment but their symptoms did not resolve. A prospective study was conducted in Shahid Sadoughi Hospital in Yazd, Iran. Several sleep indices were evaluated using polysomnography (PSG) in all patients before performing UPPP and tonsillectomy. All patients were visited 6 months after surgery and PSG was repeated to assess the efficacy of surgical intervention. A total of 48 patients were enrolled and underwent UPPP and tonsillectomy. Six months after surgery, significant improvements were observed in all indices of sleep (apnea–hypopnea index, respiratory distress index, arterial oxygen saturation, and snoring index). The score of daytime sleepiness (assessed by Epworth score) was also improved. According to the result of this study, using UPPP surgery in patients with OSA can cause symptoms improvement in 64 % of cases. It seems that Muller’s maneuver test has assisted in briefly increasing success rate after surgery, though to prove this claim; other studies should be designed and performed in a randomized clinical trial.

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References

  1. Qureshi A, Ballard RD, Nelson HS (2003) Obstructive sleep apnea. J Allergy Clin Immunol 112(4):643–651

    Article  PubMed  Google Scholar 

  2. Ancoli-Israel S, Kripke DF, Klauber MR, Mason WJ, Fell R, Kaplan O (1991) Sleep-disordered breathing in community-dwelling elderly. Sleep 14(6):486

    CAS  PubMed Central  PubMed  Google Scholar 

  3. Caples SM, Gami AS, Somers VK (2005) Obstructive sleep apnea. FOCUS: Am Psychiatr Publ 3(4):557–567

    Article  Google Scholar 

  4. Hudgel DW, Hendricks C (1988) Palate and hypopharynx–sites of inspiratory narrowing of the upper airway during sleep. Am Rev Respir Dis 138(6):1542–1547

    Article  CAS  PubMed  Google Scholar 

  5. Morrison DL, Launois SH, Isono S, Feroah TR, Whitelaw WA, Remmers JE (1993) Pharyngeal narrowing and closing pressures in patients with obstructive sleep apnea. Am Rev Respir Dis 148(3):606–611

    Article  CAS  PubMed  Google Scholar 

  6. Coughlin SR, Mawdsley L, Mugarza JA, Calverley PM, Wilding JP (2004) Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J 25(9):735–741

    Article  PubMed  Google Scholar 

  7. Tregear S, Reston J, Schoelles K, Phillips B (2009) Obstructive sleep apnea and risk of motor vehicle crash: systematic review and meta-analysis. J Clin Sleep Med Off Publ Am Acad Sleep Med 5(6):573

    Google Scholar 

  8. Piccirillo JF, Duntley S, Schotland H (2000) Obstructive sleep apnea. JAMA 284(12):1492–1494

    Article  CAS  PubMed  Google Scholar 

  9. McArdle N, Devereux G, Heidarnejad H, Engleman HM, Mackay TW, Douglas NJ (1999) Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 159(4):1108–1114

    Article  CAS  PubMed  Google Scholar 

  10. Lin C–C, Chang K-C, Lee K-S (2002) Effects of treatment by laser-assisted uvuloplasty on sleep energy expenditure in obstructive sleep apnea patients. Metabolism 51(5):622–627

    Article  CAS  PubMed  Google Scholar 

  11. Cincik H, Cekin E, Cetin B, Gungor A, Poyrazoglu E (2006) Comparison of uvulopalatopharyngoplasty, laser-assisted uvulopalatoplasty and cautery-assisted uvulopalatoplasty in the treatment of primary snoring. ORL J Otorhinolaryngol Relat Spec 68(3):149–155

    Article  PubMed  Google Scholar 

  12. Weingarten C (1995) Snareuvulopalatoplasty. Laryngoscope 105(10):1033–1036

    Article  CAS  PubMed  Google Scholar 

  13. Martínez-García MÁ, Soler-Cataluña JJ, Ejarque-Martinez L, Soriano Y, Román-Sánchez P, Illa FnB et al (2009) Continuous positive airway pressure treatment reduces mortality in patients with ischemic stroke and obstructive sleep apnea: a 5-year follow-up study. Am J Respir Crit Care Med 180(1):36–41

    Article  PubMed  Google Scholar 

  14. Drager LF, Bortolotto LA, Krieger EM, Lorenzi-Filho G (2009) Additive effects of obstructive sleep apnea and hypertension on early markers of carotid atherosclerosis. Hypertension 53(1):64–69

    Article  CAS  PubMed  Google Scholar 

  15. Marin JM, Soriano JB, Carrizo SJ, Boldova A, Celli BR (2010) Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome. Am J Respir Crit Care Med 182(3):325–331

    Article  PubMed  Google Scholar 

  16. Keenan SP, Burt H, Ryan C, Fleetham J (1994) Long-term survival of patients with obstructive sleep apnea treated by uvulopalatopharyngoplasty or nasal CPAP. Chest 105(1):155–159

    Article  CAS  PubMed  Google Scholar 

  17. Holty J-EC, Guilleminault C (2010) Maxillomandibular advancement for the treatment of obstructive sleep apnea: a systematic review and meta-analysis. Sleep Med Rev 14(5):287–297

    Article  PubMed  Google Scholar 

  18. Lin HC, Friedman M, Chang HW, Gurpinar B (2008) The efficacy of multilevel surgery of the upper airway in adults with obstructive sleep apnea/hypopnea syndrome. Laryngoscope 118(5):902–908

    Article  PubMed  Google Scholar 

  19. Conway W, Fujita S, Zorick F, Sicklesteel J, Roehrs T, Wittig R et al (1985) Uvulopalatopharyngoplasty. One-year followup. Chest 88(3):385–387

    Article  CAS  PubMed  Google Scholar 

  20. Friberg D, Carlsson-Nordlander B, Larsson H, Svanborg E (1995) UPPP for habitual snoring: a 5-year follow-up with respiratory sleep recordings. Laryngoscope 105(5):519–522

    Article  CAS  PubMed  Google Scholar 

  21. Petri N, Suadicani P, Wildschiodtz G, Bjorn-Jorgensen J (1994) Predictive value of Muller maneuver, cephalometry and clinical features for the outcome of uvulopalatopharyngoplasty. Evaluation of predictive factors using discriminant analysis in 30 sleep apnea patients. Acta Otolaryngol 114(5):565–571

    Article  CAS  PubMed  Google Scholar 

  22. Braga A, Carboni LH, do Lago T, Küpper DS, Eckeli A, Valera FC (2013) Is uvulopalatopharyngoplasty still an option for the treatment of obstructive sleep apnea? Eur Arch Otorhinolaryngol 270(2):549–554

    Article  PubMed  Google Scholar 

  23. Abreu HF, Vidaurre AS, Sarmento K, Ferreira N, Marques M, Tomita S (2000) Avaliação de novo método de uvulopalatofaringoplastia no tratamento do ronco. Arq Int Otorrinolaringol 4:122–130

    Google Scholar 

  24. Levin BC, Becker GD (1994) Uvulopalatopharyngoplasty for snoring: long-term results. Laryngoscope 104(9):1150–1152

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

No financial support was provided for this study. No author has any financial interest in the companies or products reported in this paper or has any financial disclosures related to this work.

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Correspondence to Saeid Atighechi.

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Baradaranfar, M.H., Edalatkhah, M., Dadgarnia, M.H. et al. The Effect of Uvulopalatopharyngoplasty with Tonsillectomy in Patients with Obstructive Sleep Apnea. Indian J Otolaryngol Head Neck Surg 67 (Suppl 1), 29–33 (2015). https://doi.org/10.1007/s12070-014-0735-1

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  • DOI: https://doi.org/10.1007/s12070-014-0735-1

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