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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Qureshi A, Ballard RD, Nelson HS (2003) Obstructive sleep apnea. J Allergy Clin Immunol 112(4):643–651
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
Caples SM, Gami AS, Somers VK (2005) Obstructive sleep apnea. FOCUS: Am Psychiatr Publ 3(4):557–567
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
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
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
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
Piccirillo JF, Duntley S, Schotland H (2000) Obstructive sleep apnea. JAMA 284(12):1492–1494
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
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
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
Weingarten C (1995) Snareuvulopalatoplasty. Laryngoscope 105(10):1033–1036
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
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
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
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
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
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
Conway W, Fujita S, Zorick F, Sicklesteel J, Roehrs T, Wittig R et al (1985) Uvulopalatopharyngoplasty. One-year followup. Chest 88(3):385–387
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
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
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
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
Levin BC, Becker GD (1994) Uvulopalatopharyngoplasty for snoring: long-term results. Laryngoscope 104(9):1150–1152
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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