Is uvulopalatopharyngoplasty still an option for the treatment of obstructive sleep apnea?

Abstract

Uvulopalatopharyngoplasty (UPPP) has been widely described as a surgical option for the treatment of obstructive sleep apnea syndrome. Several studies have demonstrated variable success rates, and different criteria have been used to define success of surgery. The aim of the present study was to assess the efficiency of UPPP by polysomnography and to correlate it to the clinical findings. Also, we correlated to the various studies dealing with this topic, considering the different criteria adopted in each of this. Sixty-four patients were included in the study. The efficiency of surgery for UPPP was analyzed to the variables such as body mass index, age, preoperative polysomnography results and follow-up period. Based on the criteria for postoperative cure, the success rate was 44 %. Younger patients presented a better success rate than older ones. No other correlation was found between clinical findings and UPPP success. UPPP can be curative in some patients, but combination with other treatment modalities must be considered. This should be mentioned to the patients, since in many cases the sites of airway collapse may be multiple and no clinical aspect (except for age) is indicative of good prognosis.

Evaluation of genial tubercle anatomy using cone beam computed tomography

“…The pathophysiological factors associated with OSA are very complex, ranging from those pertaining to ventilatory control or sensory function to anatomical abnormalities that may promote upper airway collapse, including skeletal, soft tissue and pharyngeal muscle factors (4,5). One specific anatomical location seems unlikely to be a major cause of upper airway collapse, and it is more probably a dynamic phenomenon involving several factors and locations (5,6).…”

The nasopharyngeal tube: A simple and effective tool to indicate the need for uvulopalatopharyngoplasty

“…Uvulopalatopharyngoplasty (UPPP) is a basic surgical procedure for treatment of OSAHS, and is effective for treating the most commonly occurring oropharyngeal obstructions. UPPP efficacy depends on accurate preoperative airway assessment and confirmation that the oropharynx is the only obstructed airway component . At this time, diagnosis and localization of the source of airway obstruction is difficult.…”

The Effect of Uvulopalatopharyngoplasty with Tonsillectomy in Patients with Obstructive Sleep Apnea

“…Some have also recommended that rhinoplasty can cause an improvement in symptoms (decrease in nightly snoring) in groups of patients who suffer from respiratory distress during sleep, but since, in the patients with OSA, the level of obstruction is usually confined to anatomical pharynx, rhinoplasty has not affected symptom improvement drastically [1,22].…”