Clin Exp Otorhinolaryngol.  2015 Jun;8(2):136-141. 10.3342/ceo.2015.8.2.136.

A Prospective Study of the Surgical Outcome of Simple Uvulopalatopharyngoplasty (UPPP), UPPP Combined With Genioglossus Advancement or Tongue Base Advancement for Obstructive Sleep Apnea Hypopnea Syndrome Patients With Multilevel Obstruction

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University of PLA, Shanghai, China. zhenghongliang99@163.com

Abstract


OBJECTIVES
To investigate the surgical outcomes of different uvulopalatopharyngoplasty (UPPP).
METHODS
All subjects underwent overnight polysomnography and were evaluated using the Epworth sleepiness scale (ESS), the Quebec sleep questionnaire and the snoring scale at the baseline and 3 and 12 months following operation. The primary endpoint was the overall effective rate representing the sum of the surgical success rate and effective rate.
RESULTS
The overall effective rate at 12 months post surgery was 55.6% for simple UPPP, 95.8% for UPPP+GA, and 92.3% for UPPP+TBA. The surgical success rate at 3 and 12 months postoperation for UPPP+GA or UPPP+TBA was significantly higher than simple UPPP (P<0.05). Marked improvement was observed in all patients in the snoring scale score and the ESS score 3 and 12 months following surgery compared to the baseline (P<0.05 in all).
CONCLUSION
UPPP, UPPP+GA, and UPPP+TBA are all effective in improving the surgical outcome of obstructive sleep apnea hypopnea syndrome (OSAHS) patients with multilevel obstruction. UPPP+TBA appears to be the most effective in treating OSAHS patients.

Keyword

Sleep Apnea Syndromes; Uvulopalatopharyngoplasty; Genioglossus Advancement; Tongue Base Advancement; Repose System; Epworth Sleepiness Scale

MeSH Terms

Humans
Polysomnography
Prospective Studies*
Quebec
Sleep Apnea Syndromes
Sleep Apnea, Obstructive*
Snoring
Tongue*
Surveys and Questionnaires

Figure

  • Fig. 1 The study flowchart. UPPP, uvulopalatopharyngoplasty; GA, genioglossus advancement with hyoid suspension; TBA, tongue base advancement with fixation.


Cited by  1 articles

A Prospective Study of the Surgical Outcome of Simple Uvulopalatopharyngoplasty (UPPP), UPPP Combined With Genioglossus Advancement or Tongue Base Advancement for Obstructive Sleep Apnea Hypopnea Syndrome Patients With Multilevel Obstruction
Shicai Chen, Song Shi, Yanghui Xia, Minhui Zhu, Caiyun Zhang, Siwen Xia, Hongliang Zheng
Clin Exp Otorhinolaryngol. 2016;9(4):387-387.    doi: 10.21053/ceo.2015.8.2.136.r1.


Reference

1. Rangel AJ, Barros VD, Seraidarian PI. Snoring and obstructive sleep apnea syndrome: a reflection on the role of dentistry in the current scientific scenario. Dental Press J Orthod. 2012; May-Jun. 17(3):58–63.
Article
2. Sher AE, Schechtman KB, Piccirillo JF. The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep. 1996; 2. 19(2):156–177. PMID: 8855039.
Article
3. Elshaug AG, Moss JR, Southcott AM, Hiller JE. Redefining success in airway surgery for obstructive sleep apnea: a meta analysis and synthesis of the evidence. Sleep. 2007; 4. 30(4):461–467. PMID: 17520790.
Article
4. Carpenter JM, LaMear WR. Uvulopalatopharyngoplasty: results of a patient questionnaire. Ann Otol Rhinol Laryngol. 2008; 1. 117(1):24–26. PMID: 18254367.
Article
5. Riley RW, Powell NB, Guilleminault C, Nino-Murcia G. Maxillary, mandibular, and hyoid advancement: an alternative to tracheostomy in obstructive sleep apnea syndrome. Otolaryngol Head Neck Surg. 1986; 94(5):584–588. PMID: 3088520.
Article
6. Handler E, Hamans E, Goldberg AN, Mickelson S. Tongue suspension: an evidence-based review and comparison to hypopharyngeal surgery for OSA. Laryngoscope. 2014; 1. 124(1):329–336. PMID: 23729234.
7. Terris DJ, Kunda LD, Gonella MC. Minimally invasive tongue base surgery for obstructive sleep apnoea. J Laryngol Otol. 2002; 9. 116(9):716–721. PMID: 12437808.
Article
8. Chinese Medical Association of Otolaryngology Branch, Chinese Journal of Otorhinolaryngology Editorial Board. Guideline for diagnosis and surgical treatment of obstructive sleep apnea syndrome. Chin J Otorhinolaryngol Head Neck Surg. 2009; 44:295–296.
9. Iber C, Ancoli-Israel S, Chesson A, Quan S. for the American Academy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Westchester (IL): American Academy of Sleep Medicine;2007.
10. Lacasse Y, Bureau MP, Series F. A new standardised and self-administered quality of life questionnaire specific to obstructive sleep apnoea. Thorax. 2004; 6. 59(6):494–499. PMID: 15170032.
Article
11. Peng LL, Li JR, Sun JJ, Li WY, Sun YM, Zhang R, et al. Reliability and validity of the simplified Chinese version of Epworth sleepiness scale. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011; 1. 46(1):44–49. PMID: 21429336.
12. Huo H, Li WY, Liu JH, Tian X, Zhou EH, Chen WD, et al. A simplified Chinese version of the Quebec sleep questionnaire was evaluated for reliability and validity. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011; 2. 46(2):101–107. PMID: 21426702.
13. Tucker Woodson B. Structural effectiveness of pharyngeal sleep apnea surgery. Sleep Med Rev. 2008; 12. 12(6):463–479. PMID: 19010290.
Article
14. Neruntarat C. Genioglossus advancement and hyoid myotomy: short-term and long-term results. J Laryngol Otol. 2003; 6. 117(6):482–486. PMID: 12818058.
Article
15. Sorrenti G, Piccin O, Latini G, Scaramuzzino G, Mondini S, Rinaldi Ceroni A. Tongue base suspension technique in obstructive sleep apnea: personal experience. Acta Otorhinolaryngol Ital. 2003; 8. 23(4):274–280. PMID: 15046416.
16. Kezirian EJ, Goldberg AN. Hypopharyngeal surgery in obstructive sleep apnea: an evidence-based medicine review. Arch Otolaryngol Head Neck Surg. 2006; 2. 132(2):206–213. PMID: 16490881.
17. Baisch A, Maurer JT, Hormann K. The effect of hyoid suspension in a multilevel surgery concept for obstructive sleep apnea. Otolaryngol Head Neck Surg. 2006; 5. 134(5):856–861. PMID: 16647548.
Article
18. Richard W, Kox D, den Herder C, van Tinteren H, de Vries N. One stage multilevel surgery (uvulopalatopharyngoplasty, hyoid suspension, radiofrequent ablation of the tongue base with/without genioglossus advancement), in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol. 2007; 4. 264(4):439–444. PMID: 17063353.
Article
19. Benazzo M, Pagella F, Matti E, Zorzi S, Campanini A, Frassineti S, et al. Hyoidthyroidpexia as a treatment in multilevel surgery for obstructive sleep apnea. Acta Otolaryngol. 2008; 6. 128(6):680–684. PMID: 18568505.
Article
20. van den Broek E, Richard W, van Tinteren H, de Vries N. UPPP combined with radiofrequency thermotherapy of the tongue base for the treatment of obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol. 2008; 11. 265(11):1361–1365. PMID: 18347810.
Article
21. Yi HL, Sun XQ, Chen B, Zhang YJ, Guan J, Wu HM, et al. Z-palatopharyngoplasty plus genioglossus advancement and hyoid suspension for obstructive sleep apnea hypopnea syndrome. Otolaryngol Head Neck Surg. 2011; 3. 144(3):469–473. PMID: 21493215.
Article
22. Khan A, Ramar K, Maddirala S, Friedman O, Pallanch JF, Olson EJ. Uvulopalatopharyngoplasty in the management of obstructive sleep apnea: the mayo clinic experience. Mayo Clin Proc. 2009; 9. 84(9):795–800. PMID: 19720777.
Article
23. Becker HF, Jerrentrup A, Ploch T, Grote L, Penzel T, Sullivan CE, et al. Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation. 2003; 1. 107(1):68–73. PMID: 12515745.
Article
Full Text Links
  • CEO
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr