Laser-assisted uvulopalatoplasty and laser uvulopalatopharyngoplasty for snoring and obsrtuctive sleep apnea: Long-term postoperative patient's satisfaction

Kim, Jae Ho; Lee, Yoon Sik; Park, Hyung Wook; Nam, Soon Yuhl; Kim, Yong Jae; Lee, Bong Jae

Abstract

BACKGROUND AND OBJECTIVES
Laser-assisted uvulopalatoplasty (LAUP) and laser uvulopalatopharyngoplasty (Laser-UPPP) are well established and highly successful operation in the treatment of snoring and obstructive sleep apnea (OSA). But, most reports are based on short-term follow-up results. This study was performed to evaluate the patient's satisfaction rate after long-term postoperative follow-up, and to investigate prognostic factors of good surgical outcome, time of recurrence, and sequelae. MATERIALS AND METHOD: 102 patients were operated by LAUP (n=77) and Laser-UPPP (n=25) between Jul,1993 and Dec,1996. These patients were followed up more than 2 years (mean 3.1 years). The degree of snoring and apnea related symptoms were evaluated using questionnaires preoperatively and postoperatively.
RESULTS
In 95 (93%) of 102 patients, symptoms were satisfationally reduced in 6 months of surgery. After 2 years the success rate dropped to 68% (70 of 102 patients. In the dissatisfied group 32 patients, most failures occurred between 6 and 12 months after surgery. Prognostic factors of good surgical outcomes were lower preoperative body mass index value, absence of postoperative weight gain, and combined nasal surgery. There was no major postoperative complication, but temporary sequalae ocurred as nasal regurgitation (8.8%), hypernasality (5.9%), pharyngeal foreign body sensation (13.7%), postoperative bleeding (6.9%), and long-lasting pain over 3 weeks (12.7%).
CONCLUSION
Long-term follow-up more than 18 months is mandatory to evaluate postoperative results of LAUP and Laser-UPPP. To achieve good postoperative outcomes in the treatment of snoring or OSA, perioperative weight reduction should be recommended, and nasal surgery should be considered in patients with nasal obstruction.