Uvulopalatopharyngoplasty versus laser assisted uvulopalatoplasty for the treatment of snoring: an objective randomised clinical trial

Osman, E.Z.; Osborne, Jonathan; Hill, Pamela D.; Lee, B.W.V.; Hammad, Z.

doi:10.1046/j.1365-2273.2000.00380.x

Cited by 37 publications

(26 citation statements)

References 31 publications

(50 reference statements)

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“…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%

“…It goes without saying that objective snoring recordings have to be reliable. Some studies have shown objective reductions in snoring after LAUP [3,5], while others have not [4]. This raises the question of whether snoring recordings are reliable.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

mentioning

confidence: 99%

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

Larrosa

Hernández²,

Morelló³

et al. 2004

European Respiratory Journal

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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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“…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%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

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

Larrosa

Hernández²,

Morelló³

et al. 2004

European Respiratory Journal

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“…There is risk of developing postoperative short-or long-term velopharyngeal insuffi ciency [15] . Osman et al [4] found a success rate of 89.9% in the postoperative period and this rate declined to 83.3% in the long-term. In our study, the postoperative success rate was 83% in UPPP patients.…”

Section: Discussionmentioning

confidence: 97%

“…Insuffi cient dilation of the upper respiratory tract muscles during sleep may result in snoring [3] . The soft palate is the most common site obstruction during snoring; however, the nose, epiglottis, tongue base, tonsils, and other regions of the upper airway tract may cause snoring [4] . Several surgical methods have been described for treatment.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Uvulopalatopharyngoplasty, Laser-Assisted Uvulopalatoplasty and Cautery-Assisted Uvulopalatoplasty in the Treatment of Primary Snoring

Cincik¹,

Cekin²,

Çetin³

et al. 2006

ORL

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Objective: Our aim was to compare the postoperative pain and surgical results of uvulopalatopharyngoplasty (UPPP), laser-assisted uvulopalatoplasty (LAUP), and cautery-assisted uvulopalatoplasty (CAUP) procedures in the treatment of primary snoring. Methods: 54 patients were stratified according to a modified Friedman staging system (MFSS) for sleep-disordered breathing. Tonsil size (1, 2, 3) and palatal position scale (grade 1–2) and body mass index <30 according to the MFSS were included for standardization. Three workgroups consisting of 18 patients each were formed and UPPP, LAUP and CAUP procedures were performed. The success of the surgical procedures was evaluated by applying the Epworth Sleepiness Scale to the patients, and the patients’ bed partners were asked to evaluate the snoring level preoperative and 45 days after the operation to determine any improvement in snoring complaints. Patients were followed for postoperative pain, secondary infection, bleeding, permanent velopharyngeal insufficiency and nasopharyngeal stenosis. Results: Snoring was relieved in 83.3% of UPPP and CAUP groups and in 88.8% of LAUP 45 days after operation. The mean pain duration was 5.71 days for the UPPP patients, 6.28 days for the LAUP patients and, 4.12 days for the CAUP patients. The mean pain score was 2.1 for the UPPP patients, 2.38 for the LAUP patients, and 1.6 for the CAUP patients. Only 1 patient was hospitalized due to pain in the LAUP group. Conclusion: The effectiveness of UPPP, LAUP and CAUP procedures were found to be similar (more than 83%). Postoperative pain was mostly seen in LAUP and UPPP cases. The CAUP procedure was easy and the least painful.

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