Analysis of the Treatment Outcomes of Obstructive Sleep Apnea Syndrome according to the Friedman Staging System

Kim, Si Whan; Moon, Il Jun; Mo, Ji Hun; Shim, Woo Sub; Lee, Chul Hee; Min, Yang Gi; Rhee, Chae Seo

Abstract

BACKGROUND AND OBJECTIVES
In 2002, Friedman et al. suggested a clinical staging system of obstructive sleep disorder patients based on palate position, tonsil size, and body mass index. The purpose of this study was to compare the treatment outcomes of uvulopalatopharyngoplasty (UPPP) and coblation assisted uvulopalatopharyngoplasty (CAUP) according to the Friedman staging system. SUBJECTS AND METHOD: Fifty patients with obstructive sleep apnea who underwent UPPP or CAUP were included. Apnea index (AI), Respiratory distress index (RDI), and Body-mass index (BMI) of preoperative polysomnography were measured. The questionnaires about snoring, apnea, and Epworth sleepiness scale (ESS) were taken by the patients and their bed partners before and after operation. All patients were stratified according to the Friedman staging system. RESULTS: Stage II patients were most common (41 cases, 82%). There was no difference in preoperative polysomnography parameters among stages. Preoperative polysomnography was decisive parameters on the determination of operative modality. UPPP was more effective than CAUP for symptom of sleep apnea with high success rate of 92.7%. CONCLUSION: In stage II, the success rates of sleep apnea and snoring were 80.4% and 63.4%. Though UPPP showed better success rate in treating sleep apnea, the success rate of CAUP in treating snoring was comparable to that of UPPP. CAUP is a good alternative to UPPP in treating snoring.