Outcomes of uvulopalatopharyngoplasty with harmonic scalpel after failure of continuous positive airway pressure in sleep apnea syndrome

Abstract

Six months after surgery: AHI decreased significantly (p < 0.05) from 31.8 ± 2.83 to 9.0 ± 0.68; ODI(4) was 2.1 ± 0.4 vs a preoperative value of 24.0 ± 1.9; ESS scores were also significantly decreased (p < 0.05) from 14.0 ± 3.7 to 4.7 ± 2.2; SL was significantly lower (p < 0.05) 1.6 ± 0.3 vs 7.9 ± 0.8. Postoperatively, patients experienced lower levels of pain and the median of time to return to normal diet was 3 days.

Anesthesia-related Safety Profile of a High-energy Ultrasonic Scalpel in Oropharyngeal and Laryngeal Surgery: An Ex Vivo Model

“…Initially developed for laparoscopic surgery in the 1960s, ultrasonic dissection has been used in a growing number of surgical procedures, including the head and neck region. In the area of the pharynx and larynx, the tool has been evaluated so far for tongue resection [4-5], tonsillectomy [6], sphincter pharyngoplasty [7], oropharyngeal cancer resection [8], uvulopalatopharyngoplasty [9], and endoscopic repair of Zenker's diverticulum [15] and for some open surgeries in close proximity to ETT as open (pharyngo) laryngectomies [16]. As with all high-energy surgical tools, a harmonic scalpel causes a local rise in the temperature.…”

“…With the abundance of high-energy surgical tools, flammable surgical materials, and the oxygen-enriched surgical field beneath the drapes and in the airway, the hazard of a surgical fire is clearly still with us, especially in surgery of the pharynx and larynx [3]. In the last decades, harmonic scalpels have been in use for various interventions in otorhinolaryngology, particularly in the pharynx and surrounding structures [4-9], which may eventually endanger the ETT. Only one report so far briefly discusses its safety with regard to the ignition of the ETT in the presence of oxygen during tracheotomies and cricothyroidotomies [10].…”

Obstructive sleep apnoea/hypopnoea syndrome: relationship with obesity and management in obese patients

“…On the other hand, soft tissue modifications can also be obtained by maxillofacial skeletal surgery, and more specifically maxillomandibular orthognathic surgery 20 . Uvulopalatopharyngoplasty involves resection of the tonsils (if present), uvula, and posterior palate and reorientation of the tonsillar pillars, eventually with the help of harmonic scalpel 95 or other devices to remove redundant mucosa and to create a neouvula. Another variant is laserassisted uvulopalatoplasty (LAUP), an outpatient surgical technique that involves a series of laser incisions and vaporisations designed to shorten the uvula and modify and tighten the soft palatal tissue 1 .…”