The Prognostic Factors of Uvulopalatopharyngoplasty in Obstructive Sleep Apnea

Park, Young Hak; Park, So Young; Park, Hae Sup; Kim, Jung Moog; Yoon, He Ro

Abstract

BACKGROUND AND OBJECTIVES: Uvulopalatopharyngoplasty (UPPP) is one of the surgical methods used to cure obstructive sleep apnea (OSA). It is designed to relieve of oropharyngeal obstruction and to enlarge the potential air space in the oropharynx by removing the excessive soft tissues involved in the free margin of the soft palate, uvula, tonsils and the pharyngeal wall. Although laser-assisted uvulopalatoplasty (LAUP) has been recently popular for the treatment of snoring and some OSA, UPPP remains the best choice of treatment for moderate to severe OSA. The criteria for selecting patients for this procedure, however, are obscure and factors that can predict successful responses are not well established. The purpose of this study was to evaluate the success rate of UPPP and to determine the factors that can predict the response to UPPP.
MATERIALS AND METHODS
We report our experience on 27 OSA patients who underwent UPPP. We evaluated their preoperative cephalometric radiograph readings as well as body mass index (BMI). Each patient also underwent polysomnography before and after UPPP.
RESULTS
Defining surgery to be successful when the postoperative apnea index (AI) was reduced by more than 50%, the success rate of the surgery was 74%. The mean AI decreased from 32 to 4, and the mean lowest oxygen saturation increased from 79% to 89% in good responders. Snoring was reduced in 67% of the patients. However, no single parameter could be used to predict good responses to UPPP.
CONCLUSION
We found that UPPP is an effective treatment for OSA, but we could not identify a single parameter which can invariably predict the success of the operation.