Dataset Information

Efficacy Analysis of Extended Uvulopalatopharyngoplasty Combined With the Simultaneous Multiplane Operation to Treat Obstructive Sleep Apnea.

ABSTRACT:

Purpose

The purpose of this study was to discuss the safety and long-term efficacy of extended uvulopalatopharyngoplasty combined with the simultaneous multiplane operation to treat obstructive sleep apnea (OSA).

Materials and methods

Sixty-two patients confirmed with OSA by polysomnography received physical examinations, determination of nasal resistance, Muller's maneuver under electronic laryngoscope, and upper airway computed tomography scan to locate the obstruction planes. Then the patients received extended uvulopalatopharyngoplasty combined with the simultaneous multiplane operation of the nasal cavity and/or tongue root under general anesthesia. Body mass index, Epworth Sleepiness Scale (ESS) score, apnea-hypopnea index (AHI), and lowest arterial oxygen saturation (LSaO2) were compared before and after surgery. Postoperative complications were recorded. All patients were followed up for 12 to 24 months after surgery. The above-mentioned indicators were determined.

Results

Fourteen patients (22.58%) achieved a cure, 20 patients (32.26%) marked effectiveness, 20 patients (32.26%) moderate effectiveness, and 8 patients (12.90%) ineffectiveness. The overall response rate was 87.10%. AHI and ESS score decreased, and LSaO2 increased after surgery than before, all in a significant manner (P<0.05). There was no significant difference in body mass index before and after surgery. No severe complications occurred in any patients.

Conclusions

Extended uvulopalatopharyngoplasty combined with the simultaneous multiplane operation had a good safety for OSA, improving ESS, AHI, and LSaO2 significantly. The patients enjoyed an improved life quality after surgery.

SUBMITTER: Yuan F

PROVIDER: S-EPMC10292567 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Efficacy Analysis of Extended Uvulopalatopharyngoplasty Combined With the Simultaneous Multiplane Operation to Treat Obstructive Sleep Apnea.

Yuan FoLiang F Wu ShuXian S Tang JiaHui J Yuan HongYan H Zhang Song S

The Journal of craniofacial surgery 20230313 5

<h4>Purpose</h4>The purpose of this study was to discuss the safety and long-term efficacy of extended uvulopalatopharyngoplasty combined with the simultaneous multiplane operation to treat obstructive sleep apnea (OSA).<h4>Materials and methods</h4>Sixty-two patients confirmed with OSA by polysomnography received physical examinations, determination of nasal resistance, Muller's maneuver under electronic laryngoscope, and upper airway computed tomography scan to locate the obstruction planes. T ...[more]

PMID: 36907843

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Project description:BackgroundTo investigate the relationship between tongue fat content and severity of obstructive sleep apnea (OSA) and its effects on the efficacy of uvulopalatopharyngoplasty (UPPP) in the Chinese group.MethodFifty-two participants concluded to this study were diagnosed as OSA by performing polysomnography (PSG) then they were divided into moderate group and severe group according to apnea hypopnea index (AHI). All of them were also collected a series of data including age, BMI, height, weight, neck circumference, abdominal circumference, magnetic resonance imaging (MRI) of upper airway and the score of Epworth Sleepiness Scale (ESS) on the morning after they completed PSG. The relationship between tongue fat content and severity of OSA as well as the association between tongue fat content in pre-operation and surgical efficacy were analyzed.Participants underwent UPPP and followed up at 3rd month after surgery, and they were divided into two groups according to the surgical efficacy.ResultsThere were 7 patients in the moderate OSA group and 45 patients in the severe OSA group. The tongue volume was significantly larger in the severe OSA group than that in the moderate OSA group. There was no difference in tongue fat volume and tongue fat rate between the two groups. There was no association among tongue fat content, AHI, obstructive apnea hypopnea index, obstructive apnea index and Epworth sleepiness scale (all P > 0.05), but tongue fat content was related to the lowest oxygen saturation (r=-0.335, P < 0.05). There was no significantly difference in pre-operative tongue fat content in two different surgical efficacy groups.ConclusionsThis study didn't show an association between tongue fat content and the severity of OSA in the Chinese group, but it suggested a negative correlation between tongue fat content and the lowest oxygen saturation (LSaO2). Tongue fat content didn't influence surgical efficacy of UPPP in Chinese OSA patients.Trial registrationThis study didn't report on a clinical trial, it was retrospectively registered.

Project description:ImportanceModified uvulopalatopharyngoplasty (mUPPP) is a surgical treatment for selected adults with obstructive sleep apnea (OSA). Tonsillectomy (TE) alone is a less extensive alternative treatment.ObjectiveTo investigate whether mUPPP is more effective than TE alone in treating adult patients with tonsillar hypertrophy and moderate to severe OSA.Design, setting, and participantsThis blinded randomized clinical trial compared the effectiveness of mUPPP with TE alone before surgery and 6 months postsurgery in adults with tonsillar hypertrophy (sizes 2, 3, or 4 according to the Friedman staging) and moderate to severe OSA in a university hospital in Stockholm, Sweden. Participants underwent surgery from January 2016 to February 2021; the last postsurgery follow-up was completed in September 2021. Data analyses were performed from January to September 2022.InterventionsmUPPP vs TE alone.Main outcomes and measuresBetween-group differences on the apnea-hypopnea index (AHI) and Epworth sleepiness scale (ESS).ResultsThe study cohort comprised 93 patients (mean [SD] age, 41.6 [9.4] years; 80 [86%] men; race/ethnicity were not considered) with a mean (SD) body mass index of 29.0 (2.8), calculated as weight in kg divided by height in m2. Of these, 90 participants (97%) completed the protocol (mUPPP, n = 45; TE, n = 45). The mean (SD) AHI score (number of events per hour [events/h]) for the mUPPP group decreased by 43%, from 51.0 (22.6) to 28.0 (20.0) events/h; and for the TE group, 56%, from 56.9 (25.1) to 24.7 (22.6) events/h. The mean between-group difference in AHI score was 9.2 events/h (95% CI, 0.5 to 17.9), with a small effect size (Cohen d = 0.44) in favor of TE. For ESS scores, the between-group difference was also small, only 1.1 (95% CI, -1.3 to 3.4; Cohen d = 0.21). Neither difference was considered to be clinically relevant.Conclusions and relevanceThis randomized clinical trial demonstrated that mUPPP was not more effective than TE alone in treating patients with tonsillar hypertrophy and moderate to severe OSA. However, there was a small difference in favor of TE. Because TE alone is less extensive, it could be considered as an alternative to mUPPP in this selected group of patients with OSA.Trial registrationClinicalTrials.gov Identifier: NCT02523248.

Project description:Background:Obstructive sleep apnea (OSA) is increasingly prevalent in the range of 2% to 24% in the US population. OSA is a well-described predictor of pulmonary complications after elective operation. Yet, data are lacking on its effect after operations for trauma. We hypothesized that OSA is an independent predictor of pulmonary complications in patients undergoing operations for traumatic pelvic/lower limb injuries (PLLI). Methods:Nationwide Inpatient Sample (2009-2013) was queried for International Classification of Diseases, Ninth Revision, Clinical Modification codes for PLLI requiring operation. Elective admissions and those with concurrent traumatic brain injury with moderate to prolonged loss of consciousness were excluded. Outcome measures were pulmonary complications including ventilatory support, ventilator-associated pneumonia, pulmonary embolism (PE), acute respiratory distress syndrome (ARDS), and respiratory failure. Multivariable logistic regression analysis was used, adjusting for OSA, age, sex, race/ethnicity, and specific comorbidities (obesity, chronic lung disease, and pulmonary circulatory disease). P<0.01 was considered statistically significant. Results:Among the 337?333 patients undergoing PLLI operation 3.0% had diagnosed OSA. Patients with OSA had more comorbidities and were more frequently discharged to facilities. Median length of stay was longer in the OSA group (5 vs 4?days, p<0.001). Pulmonary complications were more frequent in those with OSA. Multivariable logistic regression showed that OSA was an independent predictor of ventilatory support (adjusted odds ratio (aOR), 1.37; 95% CI,1.24 to 1.51), PE (aOR 1.40; 95% CI, 1.15 to 1.70), ARDS (aOR 1.36; 95% CI,1.23 to 1.52), and respiratory failure (aOR 1.90; 95% CI, 1.74 to 2.06). Conclusion:OSA is an independent and underappreciated predictor of pulmonary complications in those undergoing emergency surgery for PLLI. More aggressive screening and identification of OSA in trauma patients undergoing operation are necessary to provide closer perioperative monitoring and interventions to reduce pulmonary complications and improve outcomes. Level of evidence:Prognostic Level IV.

Dataset Information

Efficacy Analysis of Extended Uvulopalatopharyngoplasty Combined With the Simultaneous Multiplane Operation to Treat Obstructive Sleep Apnea.

Purpose

Materials and methods

Results

Conclusions

Publications

Efficacy Analysis of Extended Uvulopalatopharyngoplasty Combined With the Simultaneous Multiplane Operation to Treat Obstructive Sleep Apnea.

Similar Datasets

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