Preface

Harwick, John

doi:10.1016/j.otc.2007.05.001

Cited by 2 publications

(3 citation statements)

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“…As most of the patients have multilevel obstruction with hypopharyngeal as one of the component, UPPP that corrects retropalatal and retrolingual obstruction only is not sufficient treatment. This improved successful treatment goal with UPPP is possible only through proper selection of patients on merits of neck size and site of obstruction in addition to Friedman staging system [7, 8, 11, 13]. In addition, there was no craniofacial abnormality in our selected group, hypopharyngeal obstruction was not considered, and the sample size, once stratified, was relatively small.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Predictors for Successful Uvulopalatopharyngoplasty in the Management of Obstructive Sleep Apnea

Yousuf

Beigh

Khursheed

et al. 2013

International Journal of Otolaryngology

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Objective. To assess the clinical parameters for successful uvulopalatopharyngoplasty in the management of obstructive sleep apnoea syndrome documented with pre- and postoperative polysomnography. Materials and Methods. A study group of 50 patients diagnosed as having OSA by full night polysomnography were assessed clinically and staged on basis of Friedman staging system. BMI and neck circumference were considered, and videoendoscopy with Muller's maneuver was done in all to document the site of obstruction. The study group divided into surgical and nonsurgical ones. Twenty-two patients out of fifty were then selected for uvulopalatopharyngoplasty. The selection of surgical group was done primarily on basis of clinical parameters like neck circumference, Friedman stage of the patient and site, and/or level of obstruction of patient. Postoperative polysomnography was done six months after surgery to document the change in AHI score. Result. The study group consists of fifty patients with mean age of 44.4 ± 9.3 years. UPPP was done in twenty-two, and the result of the surgery as defined by 50% reduction in preoperative AHI with postoperative AHI < 20/h was seen to be 95.2%. Postoperative change in AHI done after 6-month interval was seen to be statistically significant with P value < 0.001. Conclusion. UPPP is ideal option for management of obstructive sleep apnoea syndrome in properly selected patients on the basis of Friedman stage and site of obstruction detected by videoendoscopy with Muller's maneuver.

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Section: Discussionmentioning

confidence: 99%

“…The reported success of UPPP as a treatment of OSA is between 16% and 83%, depending on the definition of a positive outcome and selection of patients. Some authors have defined surgical success or cure after UPPP as a 50% reduction in the AHI, whereas others combine this criterion with an absolute AHI of 20 or less [3, 6–8]. …”

Section: Introductionmentioning

confidence: 99%

Clinical Predictors for Successful Uvulopalatopharyngoplasty in the Management of Obstructive Sleep Apnea

Yousuf

Beigh

Khursheed

et al. 2013

International Journal of Otolaryngology

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“…Reported success rates of UPPP for OSA range between 16 and 83%, depending on the definition of a positive outcome and selection of patients; according to inter national journals, criteria for surgical success or cure of OSA after UPPP are: (i) a postoperative 50% reduction in apnea hypopnea index (AHI) and (ii) a residual (postoperative) AHI ≤ 20 events/hour. [11][12][13][14][15][16] However, one should consider multiple sites of obstruction in severe cases OSA. Furthermore, Riley et al [17][18][19] were the first to advocate the simultaneous perfor mance of a multilevel surgery for these patients and their invasive technique included maxillary and mandibular advancement.…”

Section: Introductionmentioning

confidence: 99%

Multilevel Surgery in Moderate to Severe Obstructive Sleep Apnea Patients

Tungkeeratichai¹,

Apirakkittikul²,

Kunachak³

2014

An International Journal of Otorhinolaryngology Clinics

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Objective The aim of this study was to investigate the objective and subjective effectiveness of multilevel surgery, i.e. combined lingualplasty with new technique of partial posterior glossectomy (PPG) and uvulopalatopharyngoplasty in moderate to severe obstructive sleep apnea (OSA) patients. Study design and setting Retrospective study of 60 OSA patients undergoing multilevel surgery for the treatment of moderate to severe OSA. Results Preoperative mean apnea hypopnea index (AHI) was 57.5 events/h and preoperative mean lowest SpO2 was 79.1%. After multilevel surgery, postoperative mean AHI significantly decreased to 29.7 events/h (p < 0.001) and postoperative mean lowest SpO2 increased to 84.4% (p < 0.001). Patients had postoperative followup assessments for 1 to 3 years. Results of surgery was classified as curative in 35/60 (58.3%) of patients, and as effective, i.e. postoperative AHI less than preoperative AHI in 52/60 patients (86.7 %). Surgery was ineffective in 8/60 (13.3%) patients. Early postoperative complications comprised early velopharyngeal insufficiency (VPI) 20% (12/60), dysarthria 20% (12/60) and wound dehiscence 3.33% (2/60) but without serious complications after 1 year. Conclusion Combined lingualplasty (with new PPG) and uvulopalatopharyngoplasty (UPPP) as multilevel surgery can be an effective treatment of choice for patients with moderate to severe OSA. No mediumterm serious complication was found. Keywords Apnea hypopnea index, Glossectomy, Lateral pharyngoplasty, Multilevel surgery in obstructive sleep apnea, Obstructive sleep apnea, Uvulopalatoplasty. How to cite this article Tungkeeratichai J, Apirakkittikul N, Kunachak S. Multilevel Surgery in Moderate to Severe Obstructive Sleep Apnea Patients. Int J Otorhinolaryngol Clin 2014;6(3):8791.

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Abstract: 2016-12-24T18:05:51

Cited by 2 publications

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Clinical Predictors for Successful Uvulopalatopharyngoplasty in the Management of Obstructive Sleep Apnea

Clinical Predictors for Successful Uvulopalatopharyngoplasty in the Management of Obstructive Sleep Apnea

Multilevel Surgery in Moderate to Severe Obstructive Sleep Apnea Patients

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