Laser-Assisted Uvulopalatoplasty in Mild Obstructive Sleep Apnea

Terris, David J.; Wang, Michelle Z.

doi:10.1001/archotol.124.6.718

Cited by 17 publications

(5 citation statements)

References 10 publications

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“…Firstly, our study confirms, in a larger sample size, the previously reported limited efficacy of LAUP in the treatment of OSA 4. It is not surprising that LAUP is less effective than traditional UPPP since the latter involves a more radical excision of palatal tissue and often incorporates a tonsillectomy.…”

Section: Discussionsupporting

confidence: 86%

“…In a recent review4 Terris and Wang identified 10 papers that included preoperative and postoperative polysomnographic data in patients with OSA who underwent LAUP. One study was prospective23 but examined only the immediate (48–72 h) postoperative effects of LAUP.…”

Section: Discussionmentioning

confidence: 99%

“…Patients may be undergoing this surgical procedure for the treatment of simple snoring without due regard for its potential impact on any associated sleep disordered breathing. The limited available data on sleep monitoring before and after LAUP, derived from studies with small sample sizes, suggest that the objective efficacy of LAUP in patients with OSA is no better than uvulopalatopharyngoplasty (UPPP) 4. Of particular concern is the possibility that LAUP might actually cause worsening of OSA in some patients 5…”

mentioning

confidence: 99%

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Unpredictable results of laser assisted uvulopalatoplasty in the treatment of obstructive sleep apnoea

Ryan

Love

2000

Thorax

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Background-Laser assisted uvulopalatoplasty (LAUP) is increasingly oVered for the treatment of obstructive sleep apnoea (OSA), although there is a lack of objective data to support its indications and eYcacy. A study was undertaken to determine the treatment response to LAUP. Methods-Overnight polysomnography was performed before and at least three months after surgery in 44 consecutive patients with symptomatic mild to moderate OSA (apnoea + hypopnoea index (AHI) >10/h). Pharyngeal dimensions were measured by videoendoscopy (n = 11) and disease-specific quality of life, sleepiness and snoring frequency (n = 16) before and after surgery were determined in subgroups of patients. LAUP was performed under local anaesthesia as a one stage resection of the uvula and soft palate by one of two experienced otolaryngologists. Results-Twelve patients (27%) had a good response (AHI <10/h after LAUP); four (9%) had a partial response (AHI <50% of pre-LAUP value); 15 (34%) had a poor response (AHI >50% of pre-LAUP value); and 13 (30%) patients were worse (AHI >100% of pre-LAUP value). The velopharyngeal cross sectional area and anteroposterior diameter increased following LAUP (p<0.05). Quality of life indices improved significantly in all domains and sleepiness decreased. The snoring index did not decrease significantly. No preoperative anthropometric or videoendoscopic measures were predictive of a good response to LAUP. Patients who were worse after LAUP had milder baseline apnoea severity than those in the other response groups. Conclusions-The treatment response to LAUP is variable and unpredictable, and only a few patients achieve a satisfactory response. There appears to be no relationship between subjective and objective measures of treatment eYcacy. (Thorax 2000;55:399-404)

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Unpredictable results of laser assisted uvulopalatoplasty in the treatment of obstructive sleep apnoea

Ryan

Love

2000

Thorax

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“…However its efficacy has not been fully proven. [124][125][126][127][128][129][130][131] Laser midline glossectomy has also been attempted to treat obstructive sleep apnea in patients who failed traditional UPPP. 132 Zenker's diverticulum is a progressive herniation of mucosa and submucosa through the posterior wall of the esophagus at the junction of pharynx.…”

Section: Future Directionsmentioning

confidence: 99%

Lasers in Dermatology and Medicine

Nouri

2012

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concerning reproduction outside those terms should be sent to the publishers. The use of registered names, trademarks, etc., in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. Cover design: eStudioCalamar, Figueres/BerlinPrinted on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) I would also like to make a dedication to my mother Mrs. Zohreh Khajavi-Noori, my father Dr. Ali Nouri, my sister Dr. Mahnaz Nouri, my uncle Dr. Farrokh Khajavi, my Grandparents and the rest of my dear family. I love you all.vii A refreshing trait of this book about lasers in dermatology is that it is the first in years, to place this topic within the broader perspective of other medical specialties. Almost immediately after the first laser was created in 1960, a handful of visionary physicians recognized that this extremely powerful source of light might have surgical applications. Those pioneers practiced in three organ systems openly accessible for light exposure -ophthalmology, dermatology, laryngology. These are still the specialties that rely heavily on surgical lasers (with the addition of urology, thanks to laser lithotripsy and prostatectomy). By far, dermatologists have a greater variety of therapeutic lasers than any other medical group, while lagging behind in other aspects of laser medicine.How did we get such a wide, almost dazzling, variety of treatment lasers in dermatology? (Because, we need them for different uses in various practice settings; lasers are the most tissue-specific surgical tools in existence.) Do we really need so many? (Well, we need most all of them. Only a few are interchangeable.) Are the mechanistic, clinical, safety, ethical and practice-related chapters of this book worthy of study? (Yes.) Can't we just learn which buttons to push, in courses provided by the more reputable device manufacturers just after a laser is purchased? (This approach is foolish beyond words, yet such fools exist. You may encounter them, and some of the patients they have harmed. Even more foolish are those who purchase a used laser and start using it without any training whatsoever.)Another asset of this text is its practicality, whether you use lasers or not. If you get hooked on laser dermatology please talk to your colleagues, and attend bona fide laser medical conferences that include your particular clinical interests, in which you are free to ask questions of faculty who are not trying to sell something. Pay close attention to the quality and source of clinical evidence regarding safety and efficacy of a particular laser device. There is no substitute for hands-on training, which cannot be obtained i...

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“…In the past two decades, laser assisted uvulopalatopharyngoplasty (LAUP) with a carbon dioxide laser emerged as an alternative to traditional methods of reshaping the soft palate and uvula and removing this redundant soft tissue in order to treat snoring. However, it is contraindicated in obstructive sleep apnea, and its efficacy has not been fully proven [138][139][140][141][142][143][144][145]. Laser midline glossectomy has also been attempted to treat obstructive sleep apnea in patients who failed traditional UPPP [146].…”

Section: Oral Cavity and Oropharyngeal Pathologymentioning

confidence: 99%

Laser/Light Applications in Otolaryngology

Rothholtz

Wong

2011

Lasers in Dermatology and Medicine

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Lasers have been ubiquitous in otolaryngology since Jako and Strong first introduced the CO 2 laser in 1970. Since that time lasers have traditionally been used like a scalpel, able to cut and cauterize precisely. More recently, the role of lasers has been expanded in otolaryngology depending on the specific laser wavelength and dosimetry parameters. Not only can lasers be utilized to extirpate cancer, but also used to recover hearing, improve the airway, treat epistaxis, and even break up salivary stones for easy removal. The individual characteristics of the laser are important for the specific application. However, the otolaryngologist often works in areas that are either difficult to access using classic methods or require extreme precision, and the mechanism and method for delivering the laser energy is often equally important. In this chapter, we describe the many ways lasers are used in otolaryngology treat both benign conditions to life-threatening diseases. New and innovative applications are also discussed.

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Laser-Assisted Uvulopalatoplasty in Mild Obstructive Sleep Apnea

Cited by 17 publications

References 10 publications

Unpredictable results of laser assisted uvulopalatoplasty in the treatment of obstructive sleep apnoea

Unpredictable results of laser assisted uvulopalatoplasty in the treatment of obstructive sleep apnoea

Lasers in Dermatology and Medicine

Laser/Light Applications in Otolaryngology

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