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Beyond uvulopalatopharyngoplasty for obstructive sleep apnoea: single surgeon case series of contemporary airway reconstruction

Published online by Cambridge University Press:  13 December 2013

S G MacKay*
Affiliation:
Department of Otolaryngology Head Neck Surgery, The Wollongong Hospital, Australia Graduate School of Medicine, University of Wollongong, Australia
N Jefferson
Affiliation:
Department of Otolaryngology Head Neck Surgery, The Wollongong Hospital, Australia
N S Marshall
Affiliation:
Sydney Nursing School, and the National Health and Medical Research Council Centre for Integrated Research and Understanding of Sleep, The University of Sydney, Australia
*
Address for correspondence: Associate Prof S G MacKay, 1–2, 8–10 Victoria St, Wollongong, NSW, Australia2500 Fax: +61 2 4227 6292 E-mail: sgmackay@ozemail.com.au

Abstract

Objective:

Adult patients with obstructive sleep apnoea can be a therapeutic surgical challenge if other treatments fail or are rejected. We report the outcomes of a series of 17 patients for whom standard device-based treatments failed or could not be used. These patients were considered unsuitable for a lesser operation and therefore underwent multilevel upper airway reconstruction.

Method:

Data from 17 consecutive patients were collected prospectively. This included pre- and post-surgery findings for clinical assessments, body mass index, sleep questionnaires, and laboratory polysomnograms. Patients underwent a combination of modified uvulopalatopharyngoplasty, transpalatal advancement and various tongue reduction procedures.

Results:

Analyses revealed statistically and clinically significant reductions in: mean apnoea-hypopnoea index scores (from 36.3 pre-operatively to 14.5 post-operatively, p < 0.001), mean Epworth sleepiness scale scores (from 11.3 to 5.3, p < 0.001) and mean snoring severity scores (from 6.9 to 1.3, p < 0.001). Body mass index remained unchanged.

Conclusion:

Multilevel upper airway reconstructive surgery was associated with large reductions in both objective and patient-centred subjective measures of obstructive sleep apnoea severity.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2013 

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Footnotes

Presented orally at the World Congress of Sleep Apnea (ENT Free Papers session 1), 27 August – 1 September 2012, Rome, Italy.

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