Uvulopalatoplasty and tonsillectomy in obstructive sleep apnea

Objective:

Obstructive sleep apnea (OSA) syndrome is a common sleep disorder caused by pharyngeal collapse during sleep and characterized by awakenings, disrupted sleep and consequent daytime sleepiness and comorbidities. The most frequent therapy is the continuous positive airway pressure (CPAP) but operative treatment defines a relevant therapy for selected patients. Uvulopalatopharyngoplasty (UPPP) is a common operation which aims to gain airwayvolume and to tense the soft palate. Common patients prejudice is the fear of postoperative pain and insufficient effect.

Methods:

All patients that underwent UPPP in 2016 and 2017 were subjected to a pre- and 8 weeks-postoperative polygraphy (PG) to quantify the OSA by detecting of the apnea-hypopnea-index (AHI). The pain was quantified by evaluation of the visual analog scale for pain (VAS) daily during hospital stay. 15 patients that underwent tonsillectomy TE) only were used as control group.

Results:

We included 15 patients from 26 to 61 years age (1 female, 14 male). Mean postoperative AHI was reduced to 18,8/h (p = 0,0044). The AHI was reduced to less than 15/h in 40% of our patients (mild OSA). The mean postoperative pain score was 1,8 in UPPP and did not differ (p = 0,42) from TE -group (1,7).

Conclusion:

In our patients we see, that UPPP is an operation that is able to improve OSA in selected Patients. The postoperative pain was not worse than in tonsillectomy patients.

Publication History

Publication Date:
23 April 2019 (online)