Four‐year follow‐up after uvulopalatopharyngoplasty in 50 unselected patients with obstructive sleep apnea syndrome

Abstract

Fifty unselected consecutive patients with obstructive sleep apnea syndrome (OSAS) diagnosed by nocturnal recordings of respiration movements by a static charge sensitive bed (SCSB) and oximetry, alone or combined with polysomnography, were studied. Renewed SCSB-oximetry recordings evaluated treatment. Six months after surgery, 30 of 50 were classified as responders. Twenty-one months after surgery, 19 of 49 were responders. Patients who relapsed showed a significant increase in mean body mass index (BMI). Four years after surgery, 24 of 48 patients were responders. Preoperative BMI was significantly lower in the responder group. Subsequent treatment was required in 15 nonresponders. There was no correlation between patients' subjective improvement and objective results. The study resulted in the following conclusions: 1. The responder rate to UPPP in unselected patients is low. 2. Obesity and high indices of nocturnal respiratory disturbance are negative predictors. 3. The patients' subjective recovery alone must not be used for postoperative evaluation. 4. With regular follow-up and the use of the treatment alternatives available today, the majority of OSAS patients can receive effective treatment.

Mortality in severe sleep apnoea/hypopnoea syndrome patients: impact of treatment

“…In the control PSG, performed in 84% of these patients, a significant reduction in sleep-disordered breathing and cure of SAHS was observed in 35%, which could have had a similar influence to that of treatment with nCPAP. It should be emphasised that patients who received both treatments maintained a weight lower than that at diagnosis, which has been proved to be an important factor in maintaining the benefits achieved with them [27,28] and which has been related to the periodic clinical follow-up [28]. Furthermore, the periodic clinical follow-up of these patients permitted the detection of therapeutic failures and establishment of alternative treatment that may have favoured the results of treatment with diet or surgery.…”

15-year efficacy of uvulopalatopharyngoplasty based on objective and subjective data

“…(3) The patients in the present study have previously been evaluated at 6 months, 2 and 4 years postoperatively regarding excessive daytime sleepiness (EDS) and renewed sleep apnoea recordings. (4) , (5) They showed significant decreases in the mean oxygen desaturation index of 4% (ODI 4 ), but 50% of the patients were regarded as failures (ODI 4 > 20 with reduction < 50%). Another long-term study on 34 patients by Janson et al, (6) using stricter success criteria (AHI < 10 with reduction > 50%), found that 52% were failures 4-8 years after UPPP surgery.…”

Uvulopalatopharyngoplasty in the Management of Obstructive Sleep Apnea: The Mayo Clinic Experience

“…We hoped that this would allow for a more uniform interval between surgery and PSG assessment. We realize a limited time window prevents detection of delayed complications that might jeopardize UPPP response over time, 28,29 such as cicatricial narrowing at the velopharyngeal-oropharyngeal junction and potential alterations in pharyngeal sensitivity, 30,31 because the effectiveness of UPPP has been shown to decrease in the long term. 32 …”