Long-term efficacy of submucosal uvulopalatopharyngoplasty for obstructive sleep apnea syndrome

Abstract

The objective of the study was the assessment of the long-term efficacy of submucosal uvulopalatopharyngoplasty in patients with obstructive sleep apnea syndrome. Thirty-two of 156 patients who underwent UPPP between January 2001 and March 2007 with a follow-up period of 36-96 months (mean, 56 months) were included in the study conducted at the university affiliated center. Preoperative and postoperative snoring evaluation forms and Epworth Sleepiness Scale (ESC) scores were used for subjective analysis. Preoperative and postoperative respiratory distress index (RDI) levels were evaluated objectively. Patients who had 50% or more reduction in RDI levels postoperatively were named as responders to the procedure. The other patients were named as non-responders. Body mass index (BMI) was also analyzed preoperatively and postoperatively. Snoring disappeared in 83% of the patients, did not change in 13% and deteriorated in 4% of the patients (p < 0.001). Excessive daytime sleepiness decreased in 22 patients (68%) and ESC values decreased from 14.6 ± 3.7 to 6.5 ± 3.9 (p = 0.0001). RDI decreased by more than 50% of the preoperative values in 15 (46.9%) of 32 patients forming the responders and the mean RDI decreased from 33.3 ± 22.9 to 23.7 ± 22.8 (p = 0.027). BMI increased over years (p = 0.0001) evidencing a preponderance in non-responder patients. Submucosal uvulopalatopharyngoplasty is an effective tool in treating patient's subjective symptoms of OSAS. Objective findings suggest that smUPPP is inadequate in treating OSAS. It cannot abolish OSAS, though it can decrease the intensity of the condition in nearly half of the patients. Weight gain decreases the success of the procedure over the years.

Long‐term Efficacy of Uvulopalatopharyngoplasty among Adult Patients with Obstructive Sleep Apnea: A Systematic Review and Meta‐analysis

“…Therefore, the results of the overall surgical response or cure rate in these studies should be lower by the common criteria. In fact, for the 6 studies 20,21,24,26-28 meeting the criteria of AHI, RDI, or ODI decreasing ≥50% and to ≤20 events/h, the pooled long-term SRR was 46.5% (95% CI, 40.3%-52.8%; n = 117 of 252), while the pooled long-term SRR of the 3 studies 21,26,27 with the criteria of AHI decreasing ≥50% and to ≤20 events/h was 48.3% (95% CI, 39.3%-57.4%; n = 59 of 122). The 3 studies with the criteria of long-term AHI <5 for surgical cure resulted in a pooled long-term SCR of 32.3% (95% CI, 23.9%-41.7%; n = 36 of 112).…”

“…Nine studies 18,20,21,23-28 provided data of long-term SRR from 28.6% to 55% with inconsistent criteria ( Table 5 ). The pooled analysis of the 9 studies resulted in an SRR of 44.4% (95% CI, 39.1%-49.7%; n = 155 of 350) without heterogeneity or inconsistency ( Q statistic P = .42; I 2 = 1%; Figure 3 ).…”

“…The pooled analysis of the 9 studies resulted in an SRR of 44.4% (95% CI, 39.1%-49.7%; n = 155 of 350) without heterogeneity or inconsistency (Q statistic P = .42; I 2 = 1%; Figure 3). The 6 studies 20,21,24,[26][27][28] meeting the criteria of respiratory events (AHI, RDI, ODI) decreasing 50% and to 20 events/h demonstrated a pooled SRR of 46.5% (95% CI, 40.3%-52.8%; n = 117 of 252; Q statistic P = .58; I 2 = 0%). For the 3 studies 21,26,27 meeting the criteria of AHI decreasing 50% and to 20 events/h, the pooled SRR was 48.3% (95% CI, 39.3%-57.4%; n = 59 of 122; Q statistic P = .28; I 2 = 22%).…”

A Comparison of Different Success Definitions in Non-Continuous Positive Airway Pressure Treatment for Obstructive Sleep Apnea Using Cardiopulmonary Coupling

“…The criteria of success vary according to the study. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Therefore, the treatment outcome cannot be directly compared on a common platform between studies. Our study also showed that the success rate ranged from 44.9% to 70.4%, according to the criterion applied.…”

“…Treatment success was defined by the following 6 criteria used in the literature: (1) posttreatment AHI < 10/h 11,14,17 ; (2) posttreatment AHI < 20/h 15,20 ; (3) reduction in the AHI > 50% and posttreatment AHI < 10/h 27 ; (4) reduction in the AHI > 50% and posttreatment AHI < 15/h 12,28 ; (5) reduction in the AHI > 50% and posttreatment AHI < 20/h 10,13,18,21,23,25,26 ; and (6) a reduction in the AHI > 50%. 24,29 …”