The Journal of Laryngology & Otology

Main Articles

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

S G MacKaya1a2 c1, N Jeffersona1 and N S Marshalla3

a1 Department of Otolaryngology Head Neck Surgery, The Wollongong Hospital, Australia

a2 Graduate School of Medicine, University of Wollongong, Australia

a3 Sydney Nursing School, and the National Health and Medical Research Council Centre for Integrated Research and Understanding of Sleep, The University of Sydney, Australia

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.

(Accepted April 08 2013)

Key words

  • Obesity;
  • Quality Of Life;
  • Polysomnography;
  • Patient Compliance;
  • Continuous Positive Airway Pressure;
  • Reconstructive Surgical Procedures

Correspondence

c1 Address for correspondence: Associate Prof S G MacKay, 1–2, 8–10 Victoria St, Wollongong, NSW, Australia 2500 Fax: +61 2 4227 6292 E-mail: sgmackay@ozemail.com.au

Footnotes

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

  Associate Prof S G MacKay takes responsibility for the integrity of the content of the paper

Competing interests: None declared