UPPP combined with radiofrequency thermotherapy of the tongue base for the treatment of obstructive sleep apnea syndrome

Broek, Emke van den; Richard, Wietske; Tinteren, Harm van; Vries, Nico de

doi:10.1007/s00405-008-0640-x

Cited by 24 publications

(22 citation statements)

References 17 publications

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“…This records the sleep architecture (derived from electroencephalogram, electrooculogram and submental electromyogram), respiration (thoracic and abdominal measurement), movements of limbs, nasal airflow and the intensity of the snoring (the last two measured by pressure sensor). Transcutaneous pulse oximetry was used to monitor oxygen saturation (SaO 2 ) and heart rate [10]. …”

Section: Methodsmentioning

confidence: 99%

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Obstructive sleep apnea is underrecognized and underdiagnosed in patients undergoing bariatric surgery

Ravesloot

Maanen

Hilgevoord

et al. 2012

Eur Arch Otorhinolaryngol

140

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The aim of this study was to evaluate prevalence of obstructive sleep apnea among patients undergoing bariatric surgery and the predictive value of various clinical parameters: body mass index (BMI), neck circumference (NC) and the Epworth Sleepiness Scale (ESS). We performed a prospective, multidisciplinary, single-center observational study including all patients on the waiting list for bariatric surgery between June 2009 and June 2010, irrespective of history or clinical findings. Patients visited our ENT outpatient clinic for patient history, ENT and general examination and underwent a full night polysomnography, unless performed previously. As much as 69.9% of the patients fulfilled the criteria for OSA (mean BMI 44.2 ± SD 6.4 kg/m2); 40.4% of the patients met the criteria for severe OSA. The regression models found BMI to be the best clinical predictor, while the ROC curve found the NC to be the most accurate predictor of the presence of OSA. The discrepancy of the results and the poor statistical power suggest that all three clinical parameters are inadequate predictors of OSA. In conclusion, in this large patient series, 69.9% of patients undergoing BS meet the criteria for OSA. More than 40% of these patients have severe OSA. A mere 13.3% of the patients were diagnosed with OSA before being placed on the waiting list for BS. On statistical analysis, increased neck circumference, BMI and the ESS were found to be insufficient predictors of the presence of OSA. Polysomnography is an essential component of the preoperative workup of patients undergoing BS. When OSA is found, specific perioperative measures are indicated.

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Section: Methodsmentioning

confidence: 99%

“…The apnea/hypopnea index (AHI) was calculated as the sum of total events (apneas and hypopneas) per hour of sleep. An AHI of 5–15/h is mild OSAS, an AHI of 15–30/h is moderate and AHI > 30/h is severe OSAS, as assessed by polysomnography [2, 10]. …”

Section: Methodsmentioning

confidence: 99%

Obstructive sleep apnea is underrecognized and underdiagnosed in patients undergoing bariatric surgery

Ravesloot

Maanen

Hilgevoord

et al. 2012

Eur Arch Otorhinolaryngol

140

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“…In most studies published on radiofrequency surgery of the base of the tongue for OSA several sessions with fewer lesions per session were performed [2, 5, 7, 10–12]. Only one study described single-session radiofrequency surgery of the base of the tongue combined with UPPP for OSA [6].…”

Section: Discussionmentioning

confidence: 99%

“…For combination of palatal and retroglossal obstruction in mild and moderate OSA combined RFBT and UPPP seems to be a very useful option of surgical treatment. However, very little has been published about its results so far [5–7]. …”

Section: Introductionmentioning

confidence: 99%

Combined bipolar radiofrequency surgery of the tongue base and uvulopalatopharyngoplasty for obstructive sleep apnea

Plzák¹,

Zábrodský²,

Kastner³

et al. 2013

aoms

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IntroductionThe aim of the study was to investigate the effectiveness of combined bipolar radiofrequency surgery of the tongue base (RFBT) and uvulopalatopharyngoplasty (UPPP) in a single session for obstructive sleep apnea and whether this combination is safe and well tolerated.Material and methodsSeventy-nine patients with obstructive sleep apnea and both palatal and retroglossal obstruction underwent UPPP with bipolar RFBT. The control group consisted of 35 patients treated by UPPP alone.ResultsThe apnea-hypopnea index significantly decreased from 28.7 to 14.1. The oxygen desaturation index decreased from 15.1 to 10.3. Mean oxygen saturation was unchanged. Subjectively, the Epworth Sleepiness Scale was significantly improved from 10.6 to 7.3, and the snoring level decreased from 8.4 to 6.0. The overall treatment success rate increased from 41.9% for UPPP alone to 51.7% for UPPP + RFBT. No serious adverse events occurred. Two patients had postoperative bleeding from the tonsillar bed after UPPP. Four patients had ulceration of the base of the tongue after RFBT with spontaneous cure. One patient had a taste change in half of the tongue that resolved within two months.ConclusionsCombined bipolar RFBT and UPPP in a single session is well tolerated and safe surgery in the treatment of obstructive sleep apnea. It is effective in reducing respiratory parameters and subjective symptoms of obstructive sleep apnea. Further advantages are a single session, simple feasibility, bipolar technique and short time of the procedure.

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“…Successful surgical outcome of UPPP may be defined as a 50% reduction in the AHI, or we can combine this criterion with an absolute AHI of 20 or less. UPPP combined with radiofrequency thermotherapy of the tongue base in selected patients with OSAS seems to be more successful than UPPP alone [34]. …”

Section: Discussionmentioning

confidence: 99%

Selected surgical managements in snoring and obstructive sleep apnea patients

et al. 2012

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SummaryBackgroundThe diagnostic process and the surgical procedures in patients with snoring and obstructive sleep apnea syndrome (OSAS) are crucial. The aim of this study was to assess the efficacy of surgical treatment in snoring and OSAS patients.Material/MethodsA precise laryngological examination and screening polysomnography (Poly-Mesam) were performed in all patients with mild, moderate and severe OSAS before and 6 months after surgery. The patients completed questionnaires concerning their complaints. We included patients qualified to septoplasty, laser-assisted uvulopalatoplasty (LAUP), uvulopalatopharyngoplasty (UPPP) and radiofrequency-induced thermotherapy of the tongue base (RITT). Outcome evaluation of surgery was performed on the basis of data received from follow-up laryngological examinations, selected parameters obtained from the Poly-Mesam test and follow-up questionnaires.ResultsIn most cases we observed improvement, defined as decreasing some sleep parameters, such as a respiratory disturbance index (RDI), by more than 50%, decreasing the loudness of snoring, decreasing the number of hypopneas, and obtaining better blood saturation values. After UPPP we noticed changes in retropalatal space, soft palate dimensions and uvula-posterior pharyngeal wall distance. In the postoperative period we did not observe severe complications. In some cases we found short-lived palatal deficiency after UPPP. Patients after RITT experienced discomfort and throat pain lasting from 2 to 4 days. In 2 patients we observed swelling of the tongue base, which decreased after few days.ConclusionsSurgery in OSAS contributes to normalization of some sleep parameters. The majority of patients experienced improvement after surgery.

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UPPP combined with radiofrequency thermotherapy of the tongue base for the treatment of obstructive sleep apnea syndrome

Cited by 24 publications

References 17 publications

Obstructive sleep apnea is underrecognized and underdiagnosed in patients undergoing bariatric surgery

Obstructive sleep apnea is underrecognized and underdiagnosed in patients undergoing bariatric surgery

Combined bipolar radiofrequency surgery of the tongue base and uvulopalatopharyngoplasty for obstructive sleep apnea

Selected surgical managements in snoring and obstructive sleep apnea patients

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