Purpose. To study specific approaches for selecting patients with rhonchopathy and obstructive sleep apnea syndrome for surgical treatment and to study laser surgical techniques applied on the soft palate so as to identify basic reasons of postoperative complications, soft palate function disorders and relapses of the disease with an even more aggressive course than before the surgery.Material and methods. In 2011–2020, 523 patients with rhonchopathy and obstructive sleep apnea syndrome, aged 23–78, were selected for surgical treatment. The authors discuss the obtained data after analyzing the effectiveness of used criteria for selecting patients for laser-assisted surgery on the soft palate, as well as after analyzing outcomes after laser sculptural uvulopalatoplasty performed in 309 patients. Reasons for insufficient effectiveness of surgery in some patients have been analyzed too.Results. After analyzing selection criteria, it has been found out that only 309 patients out of 523 (59.1 %) had no contraindications to laser sculptural uvulopalatoplasty, while 214 patients (40.9 %) had them. The discussed surgery was effective in 304 out of 309 operated patients (98.4 %) which has been confirmed with a complete and stable relief from night snoring and its complications for five or more years after the surgery. No effect was registered in 5 (1.6 %) patients because they absolutely ignored strict following the prescribed regimen, diet and other recommendations aimed to promote physiological healing of surgical wounds.Conclusion. The effectiveness of laser sculptural uvulopalatoplasty depends on a careful and adequate selection of patients for this surgery as well as on rational choice of laser light parameters; failures are due to inadequate selection of patients and their unwillingness to strictly follow recommendations in the postoperative period.

The authors have reviewed researches on laser palate surgery and stages of its historical development for providing surgical care to patients with ronchopathy and the obstructive sleep apnea syndrome. They also assessed the effectiveness of traditional techniques for uvulopalatoplasty as well as the effectiveness of laser light application in uvulopalatoplasty and its modifications.

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Purpose: to study anatomical and physiological features of the soft palate in patients with rhonchopathy and obstructive sleep apnea (OSA) syndrome so as to minimize damage to tissue structures during laser uvulopalatoplasty.Material and methods. Five hundred twenty-three patients with rhonchopathy and OSA syndrome were examined using the index technique for determining neck circumference-height ratio (NHR), pharyngoscopy and endoscopy of the oral and pharyngeal cavities.Results. Obstructive sleep apnea syndrome is more often met in patients having rhonchopathy and the brachymorphic and mesomorphic type of their neck. The researchers have found a clear dependence between the increase in the number of patients having rhonchopathy and moderate and severe obstructive sleep apnea syndrome and the increase of soft palate hypertrophy combined with ptosis. A cone-shaped depression on the anterior surface of the soft palate was noted in 80-90 % of patients with normal weight (body mass index < 25); in 40–60 % of patients with grade I obesity (body mass index – 30–34.9); in 10–15 % of patients with grade II obesity (body mass index – 35–39,9); in patients with grade IIIobesity (body mass index > 40) there were no any depression in the soft palate. Patients with uncomplicated snoring have a thick area in the forma pillow at the back of their soft palate sized 1 × 0.5 × 0.5 cm, while in patients with severe OSA syndrome this «pillow» is up to 2 × 1.5 × 1 cm.Conclusion. The effectiveness of laser uvulopalatoplasty depends not only on the adequate choice of main parameters for laser irradiation, but also on the careful consideration of anatomical and functional features of the soft palate in each operated patient with rhonchopathy and obstructive sleep apnea syndrome.