Effect of laser-assisted uvulopalatoplasty on oral airway resistance during wakefulness in obstructive sleep apnea syndrome

Abstract

The aim of the study was to evaluate the effects of successful laser-assisted uvulopalatoplasty (LAUP) on oral airway resistance (R(OA)) during wakefulness in patients with OSAS. Fifteen healthy subjects (group I) and 25 subjects (group II) with moderately severe or severe obstructive sleep apnea syndrome (OSAS) proven by an overnight sleep study and who desired LAUP were enrolled. All underwent an overnight sleep study, pulmonary function testing and measurement of oral airway resistance [R(OA) (including impedance (Zrs), resistance (R) and reactance (X)] measurement by Impulse Oscillometry (IOS) (MasterScreen IOS, VIASYS Healthcare GmbH, Germany) in the upright (seated) position and then in the supine position while awake. Group II subjects had these measurements twice, both before and 3 months after LAUP. Based on the assessment of their sleep study after LAUP, they were divided into two groups: responders (group IIa) and nonresponders (group IIb). Zrs was normal in the sitting position both before and after LAUP in both groups IIa and IIb and comparable to that of group I controls. There was an increase in Zrs in the supine position in both groups IIa and IIb subjects before LAUP. After LAUP, the Zrs in group IIb subjects remained elevated, while that in group IIa subjects returned to levels comparable to those in the normal controls. OSAS patients before LAUP have abnormal R(OA) in the supine position as reflected by a high Zrs. The Zrs is improved after LAUP that successfully ameliorates OSAS.

Impulse oscillometry in the evaluation of diseases of the airways in children

“…30 In obstructive sleep apnea syndrome, IOS has been used to evaluate the degree of upper airway obstruction, 31 determine the optimal continuous positive airway pressure required to treat the obstruction, 32 and estimate the resolution of obstruction subsequent to surgical intervention. 33 …”

Polysomnography outcomes on patients with obstructive sleep apnea after upper airways repermeabilization surgery

“…Apnea is described as airflow discontinuity at the level of the nose and the mouth that lasts more than 10 seconds and which is objectified by using an infrared CO2 analyser, that has the purpose to record from both the nose and the mouth and a pulsoxymetric sensor that records the level of oxygen saturation from the index finger 6,7 .…”

“…Hypopnea is represented by a decline of more than 50% in the excursion of the sum channel of a respiratory inductance plethysmography measuring chest wall and abdominal movement 6,7 .…”

Effect of Uvulopalatopharyngoplasty on Work of Breathing during Wakefulness in Obstructive Sleep Apnea Syndrome

“…The impedance improved after operation in subjects in whom the procedure successfully ameliorated OSAS. 20 The use of Pes to measure the WOB was introduced by Campbell et al, 15 and this technique has been used widely for ventilated patients in intensive care units. 21 We therefore used esophageal manometry in the present study and had results very similar to those in our earlier study.…”