A new technique for laser‐assisted uvulopalatoplasty: Decision‐tree analysis and results

Remacle, Marc; Betsch, C.; Lawson, Georges; Jamart, Jacques; Eloy, Philippe

doi:10.1097/00005537-199905000-00015

Cited by 24 publications

(12 citation statements)

References 16 publications

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“…The one-stage LAUP procedure used in the current study is comparable to other LAUP techniques in effectiveness [15][16][17][18][19] and does not account for the negative results obtained. A follow-up of 3 months should be enough to reveal differences between the groups.…”

Section: Discussionmentioning

confidence: 92%

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Laser-assisted uvulopalatoplasty for snoring: does it meet the expectations?

Larrosa

Hernández²,

Morelló³

et al. 2004

Eur Respir J

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The high prevalence of habitual snoring (35% of the general population) and the increasing demand for an effective treatment have led, in the last decade, to the generalisation of laser-assisted uvulopalatoplasty (LAUP). However, acceptable studies on its effectiveness are lacking.The present randomised, placebo-controlled study included 25 nonapnoeic and mild obstructive sleep apnoea snorers to evaluate LAUP effectiveness for snoring. Group I received a one-stage LAUP treatment and group II a placebo (simulated snore surgery followed by an oral placebo). Before each treatment and 3 months after, the variables and procedures assessed were: body weight; sleepiness (Epworth sleepiness scale); quality of life (SF-36); subjective snoring intensity (0-10 analogue scale); objective snoring intensity (average decibel intensity); snoring index (number of snores per hour); and apnoea/hypopnea index.No differences were observed in body weight, sleepiness, quality of life, subjective and objective intensity, and frequency of snoring, and apnoea/hypopnea index between the groups before and 3 months after treatment.In conclusion, this study provides evidence of the lack of effectiveness of one-stage laser-assisted uvulopalatoplasty for snoring in nonapnoeic and mild obstructive sleep apnoea patients, with the result that it does not meet the expectations generated by the procedure. Laser-assisted uvulopalatoplasty (LAUP) is an outpatient procedure that involves partial resection of the uvula and soft palate using a laser. It is usually offered as a treatment for snoring or as an alternative treatment in mild obstructive sleep apnoea (OSA). However, methodologically accepted studies on the effectiveness of this treatment are limited since randomised placebo-controlled studies are lacking [1]. The high prevalence of habitual snoring (35% of the general population) [2] and the increasing demand for an effective treatment have led, in the last decade, to the generalisation of LAUP. Its indication has probably been favoured by the widespread belief that surgical procedures are more decisive. Furthermore, disparate results concerning this procedure have been published on the basis of objective measurements of snoring before and after treatment [3][4][5]. This, together with the potential risks and complications of LAUP [1], has cast doubt on the need for treating nonapnoeic snorers [6], and the high cost of treating a growing number of patients has led to the usefulness of LAUP being challenged. Thus, further evidence in support of this treatment is warranted. Accordingly, the authors of the present study conducted a prospective, randomised, placebo-controlled study in patients whose main symptom was disruptive snoring (male sex, age range 30-60 yrs, body mass index (BMI) range 25-30 kg?m -2 , apnoea/ hypopnea index (AHI) f30 and considered to be palatal snorers) to evaluate the effect of LAUP in relieving snoring both subjectively and objectively. Material and methods Study subjectsEntry criteria specified: an initial c...

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Section: Discussionmentioning

confidence: 92%

“…Benefits of LAUP for snoring have been evaluated in earlier studies [3][4][5][15][16][17][18][19][20][21]. These studies showed subjective improvement in snoring.…”

Section: Discussionmentioning

confidence: 99%

Laser-assisted uvulopalatoplasty for snoring: does it meet the expectations?

Larrosa

Hernández²,

Morelló³

et al. 2004

Eur Respir J

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“…Studies report subjective short-term success rates for the elimination or near elimination of snoring in the range of 60-92% [24,42,45,49,50]. As observed with UPPP, objective evaluation shows a reduced snoring volume after LAUP, but this does not correlate highly with subjective assessment [51].…”

Section: Treatment Of Snoringmentioning

confidence: 99%

“…The procedure should be repeated on average three times to achieve the elimination of snoring. Several variations of LAUP have been described with comparable effects on snoring [45][46][47]. Controversy exists concerning the anatomical consequences of LAUP.…”

Section: Laser-assisted Uvulopalatoplastymentioning

confidence: 99%

“…LAUP has been reported to reduce morbidity, such as pain, bleeding, nasal regurgitation, dryness and pharyngeal discomfort when compared with UPPP [50]. However, recent studies have demonstrated that the morbidity is similar [40,45,52,53]. Therefore, the advantage of LAUP over UPPP is that it can be performed under local anesthesia, requires no hospitalization and is less expensive.…”

Section: Treatment Of Snoringmentioning

confidence: 99%

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Obstructive Sleep Apnea Syndrome and Snoring: What Is the Role of Surgery?

Pelletier¹,

Pellanda²,

Jaques³

2000

Otorhinolaryngol Nova

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This paper evaluates the different surgical treatments used in obstructive sleep apnea syndrome and snoring. This critical analysis is based on an extensive review of the literature and the authors’ experience. In snoring patients, the success rate of surgery focusing on the soft palate does not exceed 50–60%, and the risk of pharyngeal narrowing is high. Therefore, this treatment should be selectively performed. More conservative approaches are now under development. The surgical treatment of the obstructive sleep apnea syndrome is controversial. Surgery of the soft palate is associated with a high rate of complications and, therefore, is restricted to a limited number of cases. The compliance with continuous positive airway pressure is low, especially among young patients. Therefore, maxillofacial surgery has regained interest with two opposite concepts. Some authors favor a step-by-step approach, while others proceed in a one-stage surgery. The latter is more aggressive, but its success rate is superior (90%). Results and indications of hyoid myotomy and suspension associated with genioplasty (phase 1) and maxillomandibular osteotomy and advancement (phase 2) are reviewed in detail.

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