Efficacy of weight management combined with uvulopalatopharyngoplasty for obesityrelated obstructive sleep apnea-hypopnea syndrome / 南方医科大学学报

OBJECTIVE@#To evaluate the clinical efficacy of weight management combined with pharyngoplasty for treatment of obesity-related obstructive sleep apnea-hypopnea syndrome (OSAHS).@*METHODS@#Sixty obese patients with OSAHS were randomly assigned into the combined treatment group and control group (@*RESULTS@#After 6 months of treatment, the patients receiving the combined treatment showed significant reductions of BMI, neck circumference and waist circumference as compared with the measurements before treatment and with those in the control group (@*CONCLUSIONS@#Weight management combined with uvulopalatopharyngoplasty can produce a good clinical efficacy for treatment of OSAHS with obesity, and the patients should have strengthened continuous family weight management while receiving surgical treatment.

Observation on curative effect of low-temperature plasma assisted uvulopalatopharyngoplasty in positional and non-positional OSAHS patients / 重庆医学

Objective To investigate the curative effect of low-temperature plasma-assisted uvulopalatopharyngoplasty(UP-PP)in the patients with positional and non-positional obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods Twenty-six patients with OSAHS diagnosed by polysomnography monitoring receiving the low-temperature plasma-assisted UPPP in our hospital from January 2014 to December 2015 were selected and divided into the positional OSAHS group(PPs) and non-positional OSAHS group(NPPs) according to the apnea-hypopnea index (AHI) under different sleep positional status.The AHI change before and after operation and operation effective rate were compared between the two groups.Results Theoverall AHI,supine position AHI and lateral position AHI in the PPs group all were lower than those in the NPPs group(P＜0.05),moreover the blood oxygen related indexes were higher than those in the NPPs group(P＜0.05).The overall surgical effective rate in the OSAHS patients was 73.08％ (19/26),in which the surgical effective rate was 100％ (7/7) in the PPs group and 63.16％ (12/19) in the NPPs group,the difference between the two groups had no statistical significance(P=0.13).The postoperative total AHI,supine position AHI and lateral position AHI in the two groups were decreased compared with before operation(P＜0.05);the decrease range of lateral position AHI in the NPPs group was significantly higher than that in the supine position AHI[0.96(0.86,1.00)vs.0.53(0.34,0.77),P＜0.01].78.95 ％ (15/19) postoperation patients in the NPPs group converted to PPs.Conclusion Low-temperature plasma-assisted UPPP has some effects on OSAHS patients,in which the benefit of NPPs are more apparent.

Effects of dexmedetomidine on the perioperative stress in patients undergoing uvulopalatopharyngoplasty / 临床麻醉学杂志

Objective To observe the effects of dexmedetomidine on the perioperative stress in patients undergoing uvulopalatopharyngoplasty (UPPP).Methods Sixty patients scheduled for uvulopalatopharyngoplasty (UPPP), all males, aged 18-65 years, of ASA physical status Ⅰ or Ⅱ, were selected randomly.Then the patients were divided into dexmedetomidine group (group D) and control group (group C), 30 patients in each group.The patients of group D were administered 1.0 μg/kg bolus dose of dexmedetomidine over 10 min before tracheal intubation, followed by 0.5 μg·kg-1·h-1 infusion for 12 hours in ICU after surgery.And the patients in group C were given normal saline instead as in group D.The levels of MAP, HR, PaO2, PaCO2, norepinephrine (NE), epinephrine (E), cortisol (Cor), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were recorded at time points of entering operating room (T0), tracheal intubation (T1), 30 min after operation (T2), upon entering ICU (T3), and extubation (T4).Results HR of group D was significantly slower than that of group C during T1-T4 (P<0.05).MAP of group D was lower than that of group C during T1-T4 (P<0.05).The levels of NE, E, Cor, IL-6, TNF-α of group D were significantly lower than that of group C during T1-T4(P<0.05).Compared with group C , the incidence of cough reflex during extubation was lower in group D significantly (P<0.05).Conclusion Intravenous infusion of dexmedetomidine can suppress perioperative stress effectively and stabilize hemodynamics for the patients undergoing UPPP without prolonging the recovering time, extubation time and the duration in ICU.

Multimode and comprehensive treatment for relieving discomfort after uvulopalatopharyngoplasty / 中国耳鼻咽喉头颈外科

OBJECTIVE To observe the effect of multimode comprehensive treatments on relieving discomfort during postoperative 7 days in patients after uvulopalatopharyngoplasty (UPPP).METHODS A total of 60 patients who underwent UPPP were randomly divided into experimental group and control group.Multimode comprehensive therapy was applied in experimental group(n=30) during postoperative consecutive 7 days,which included gastrogavage,whole pharynx cavity cleaning care with aspirator,intravenous flubiprofen axetil injection 100 mg two times a day,nebulization of budesonide suspension liquid 2 mg two times a day.The treatment methods in control group(n=30) included liquid or soft diets,routine oral cavity care.Visual analogue scale (VAS) was applied to evaluate the discomfort degree including pharyngeal pain,globus and pharyngeal mucus accumulation.The incision healing degree was also recorded.RESULTS VAS scores were highest(6-7.5) in the first two days after UPPP in control group.Compared with control group,the scores of pharyngeal pain,globus and pharyngeal mucus accumulation were lower and the rate of incision complete heal was higher(53.3％) in experimental group(P＜0.05).CONCLUSION The period of most severe pharyngeal discomfort after UPPP is within 48 hours after operation.Multimode comprehensive treatment can relieve pain,improve subjective globus feeling and mucus accumulation,and promote incision healing.

The tolerance of contemporaneous multiplane operations in obstructive sleep apnea-hypopnea ;syndrome / 中国医师进修杂志

Objective To observe the tolerance of contemporaneous multiplane operations in obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods Twenty-three patients were enrolled. According to the different obstructive level, the different operations were chosen to complete upper airway reconstruction in contemporaneous operation group (group A, 13 patients). In the simple palatopharynx level obstructive group (group B, 10 patients), bilateral tonsillectomy and H-UPPP was chosen. Results The operation time in group A was significantly longer than that in group B:(121.0 ± 35.4) min vs.(80.7 ± 25.3) min, P0.05). Conclusions Individual therapeutic schedule for OSAHS patients should be formulated. Operating the different obstructive levels simutaneously, which would solve upper airway occlusion and complete the upper airway reconstruction at the same time. No more adverse events happen, compared with the simple palatopharynx level obstructive group, though the operation time may be longer.

Effects of oxycodone early analgesia on stress response in patients undergoing uvulopalatopharyngoplasty / 临床麻醉学杂志

Objective To study effects of oxycodone post-operative early analgesia on stress re-sponse with in diabetics undergoing uvulopalatopharyngoplasty (UPPP).Methods Eighty patients undergoing UPPP,53 males,27 females,aged 28-65 years,ASA Ⅰ or Ⅱ were randomly divided in-to two groups(n =40).1 5 minutes before the end of the operation,group O was intravenously given oxycodone 0.07 mg/kg;Group F fentanyl 0.7 μg/kg.The patients of the two groups were sampled venous blood 3 ml in the morning of operation (T1 ),postoperative 1 hour (T2 ),postoperative 3 hours (T3 )for determination of serum cortisol (Cor),serum insulin(Ins),serum C-peptide(C-P)u-sing electrochemical luminescence method.Results Cor at T2 ,T3 was lower than that at T1 , C-P was higher than that at T1 (P <0.05)in group O,respectively;Cor at T2 ,T3 was higher than that at T1 , respectively,C-P was lower than that at T1 (P <0.05);Cor in group F was higher than that in group O,C-P in group F was lower than that in group O(P <0.05).Ins at T2 ,T3 was lower than that at T1 and was lower than that in group O(P <0.05).Conclusion Oxycodone 0.07 mg/kg early analgesia for UPPP significantly inhibits the occurrence of stress response.

Flurbiprofen Combined with Sufentanil for Analgesia After Han-uvulopalatopharyngoplasty Surgery / 中国微创外科杂志

Objective To evaluate the analgesic efficiency and safety of patient-controlled intravenous analgesia ( PCIA) with both flurbiprofen and sufentanil after Han-uvulopalatopharyngoplasty ( H-UPPP) surgery. Methods Patients undergoing H-UPPP surgery ( n=60 ) were randomly divided into four groups with 15 cases in each group .They received PCIA after operation with a loading dose of 2 ml, lockout time of 15 minutes, background infusion rate of 2 ml/h and liquid volume of 100 ml.The PCIA formulation in each group was as follows:sufentanil 3.0 μg/h in group A;sufentanil 3.0 μg/h+flurbiprofen 4.0 mg/h in group B;sufentanil 2.0μg/h+flurbiprofen 4.0 mg/h in group C;sufentanil 1.0μg/h+flurbiprofen 4.0 mg/h in group D.The visual analogue scale (VAS) and Ramsay sedation scale were recorded at 2, 6, 12, 24, and 48 h after surgery (T1 -T5 time points).Patient pressing times and the adverse effects within 48 h after surgery were counted . Results The VAS scores of the group D were higher than those in the other three groups at T1 and T2 time points (P<0.05).The Ramsay scores of the group D were lower than those in the other three groups at T1 and T2 time points (P<0.05).The numbers of pressing times in the group D were more than those in the other three groups (P<0.05). Conclusion PCIA with both flurbiprofen 4.0 mg/h and sufentanil 2.0 μg/h is effective for postoperative analgesia after H-UPPP.

The Effect of Uvulopalatopharyngoplasty on Voice in Patients with OSAHS / 听力学及言语疾病杂志

Objective To study the impact of changes in the pharynx on the vocal functions and resonance functions to evaluate the effects of UPPP on voice and in order to provide a reference for the selection of UPPP sur‐gery population .Methods The 30 male adult patients who underwent UPPP surgery were recorded pre-surgery ,1-week post-surgery and 3-month post-surgery speech .Then the multi-dimensional voice program (MDVP) , linear prediction coding (LPC) ,the Nasometer Ⅱ(model 6450) were used to evaluate the vocal functions ,the oral resonance functions and the nasal resonance function .Results F0 ,jitter ,shimmer ,and NHR were unchanged from the pre-surgery to the post-surgery condition .One week after the surgery ,F1 ,F2 of /a/,/i/and /u/were un‐changed (P>0 .05) .Three months after surgery ,F1 ,F2 of the vowel /a/and F1 of the vowel /u/were remained essentially unchanged (P>0 .05);while the frequency of F1 ,F2 of the vowel /a/and of F2 of the vowel /u/were significantly higher compared to pre-surgery values (P0 .05) .Three months after surgery ,the nasalance scores of the oral sentence and the oranasal sentence were unchanged (P>0 .05);while the nasalance scores of the nasal sentence were significantly higher compared to pre-surgery values (P<0 .05) .Conclu‐sion UPPP doses not affect the vocal function .But it might have a certain effect on resonance function ,demonstra‐ted by the change of several formant frequency and nasalance .UPPP in all professional voice users should be cau‐tious .Such patients who want to undergo UPPP must be informed of this potential modification of the voice after sursery .

A Prospective Study of the Surgical Outcome of Simple Uvulopalatopharyngoplasty (UPPP), UPPP Combined With Genioglossus Advancement or Tongue Base Advancement for Obstructive Sleep Apnea Hypopnea Syndrome Patients With Multilevel Obstruction

OBJECTIVES: To investigate the surgical outcomes of different uvulopalatopharyngoplasty (UPPP). METHODS: All subjects underwent overnight polysomnography and were evaluated using the Epworth sleepiness scale (ESS), the Quebec sleep questionnaire and the snoring scale at the baseline and 3 and 12 months following operation. The primary endpoint was the overall effective rate representing the sum of the surgical success rate and effective rate. RESULTS: The overall effective rate at 12 months post surgery was 55.6% for simple UPPP, 95.8% for UPPP+GA, and 92.3% for UPPP+TBA. The surgical success rate at 3 and 12 months postoperation for UPPP+GA or UPPP+TBA was significantly higher than simple UPPP (P<0.05). Marked improvement was observed in all patients in the snoring scale score and the ESS score 3 and 12 months following surgery compared to the baseline (P<0.05 in all). CONCLUSION: UPPP, UPPP+GA, and UPPP+TBA are all effective in improving the surgical outcome of obstructive sleep apnea hypopnea syndrome (OSAHS) patients with multilevel obstruction. UPPP+TBA appears to be the most effective in treating OSAHS patients.

Application of Two Kinds of Video Laryngoscope in General Anesthesia during UPPP Operation / 天津医药

Objective To compare success rate of intubation and safety of two types of video laryngoscopes during anesthesia in uvulopalatopharyngoplasty surgery (UPPP) for obstructive sleep apnea syndrome (OSAS) patients. Methods UPPP surgery were operated to 60 patients between January and October of 2013 and those patients were randomly divided into McGrath MAC video laryngoscope group (M group), GlideScope video laryngoscope (G group), and SHUCMAN direct la-ryngoscopy (S group), with 20 patients per group. Mallampati classification scores, Cormack-Lehane grade, intubation suc-cess rate, pre-intubation vs post-intubation heart rate and blood pressure changes were recorded and compared. Results Mallampati classification scores were not significantly different between these three groups, and Cormack-Lehane grade be-tween M group and G group were also not statistically different. M and G group had distinct advantages in Cormack-Lehane grade, success rate in intubation, heart rate, blood pressure at completion of intubation (T3) and 1 minute after intubation (T4), and the differences are statistically significant (P < 0.05). Blood pressure changes were stabler in G group than M group. Conclusion The two video laryngoscopes used in anesthesia intubation during UPPP surgery can both effectively re-veal the structure of the throat, but also work with high success rate and safety. What’s more, in this study the McGrath MAC video laryngoscope was shown to be superior to GlideScope video laryngoscope.

Upper airway changes after H-uvulopalatopharyngoplasty combined with transpalatal advancement pharyngoplasty in patients with obstructive sleep apnea hypopnea syndrome / 中国医师进修杂志

Objective To compare the upper airway changes after H-uvulopalatopharyngoplasty (H-UPPP) combined with transpalatal advancement pharyngoplasty (PA) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Eighty-six patients with OSAHS were selected,39 patients were treated with H-UPPP alone (control group),and 47 patients were treated with H-UPPP combined with PA (observation group).The upper airway changes were measured by CT and apnea hypopnea index (AHI) change in the 2 groups were compared before and after operation.Results The surgery effective rate in observation group was 80.9％ (38/47),in control group was 56.4％ (22/39),there was statistical difference (P ＜ 0.05).The AHI depressed value before and after operation in observation group and control group were (40.5 ± 14.6) times/h and (16.7 ± 12.0) times/h respectively,the hard palate length depressed value were (5.5 ± 3.2) mm and (1.6 ± 0.2) mm respectively,the anteroposterior diameter incremental value of hard palate were (3.6 ± 2.3) mm and (-1.6 ± 3.4) mm respectively,the anteroposterior diameter incremental value of palate and pharynx were (1.6 ± 1.2) mm and (-1.2 ± 1.8) mm respectively,the above indexes in observation group were significantly better than those in control group,there were statistical differences (P ＜ 0.05).The minimum diameter incremental value of retropalatal airway in control group was (13.2 ± 3.1) mm,in observation group was (4.9 ± 1.6) mm,there was statistical difference (P ＜ 0.05).Conclusion H-UPPP combined with PA offers benefit over H-UPPP alone in patients with OSAHS,which may be achieved by increasing anteroposterior diameter of palate and pharynx.

Drug Induced Sleep Endoscopy for Poor-Responder to Uvulopalatopharyngoplasty in Patient with Obstructive Sleep Apnea Patients / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study is to evaluate drug-induced sleep endoscopy (DISE) findings in patients with persistent obstructive sleep apnea (OSA) after uvulopalatopharyngoplasty (UPPP) surgery. SUBJECTS AND METHOD: Patients were included in this study if they had a postoperative DISE evaluation as well as pre- and postoperative polysomnography. DISE findings included the obstructive sites (velum, oropharyngeal lateral walls, tongue base, and epiglottis), and the obstructive patterns of velopharynx (anteroposterior, lateral, and concentric). RESULTS: A total of 77 patients were included in this study. Poor-responder patients to UPPP (n=50) and well-responder patients to UPPP (n=27) were similar with regard to age, gender, body mass index, preoperative AHI, and minimal O2 saturation. In our analysis of DISE findings on poor-responder, velopharynx was the most common obstruction site (100%), followed by oropharynx (88%), tongue base (70%), and epiglottis (44%). Results showed that most patients (n=49) had multiple obstructive sites. No significant differences according to position dependency and REM dependency were found in obstructive sites. However, severe OSA patients had tongue base obstruction more frequently than the moderate OSA patients did. The obstructive pattern of velopharynx usually showed concentric configuration (70%, 35 of 50). CONCLUSION: Our results suggest that the preoperative DISE may be a useful method for determination of the personalized surgery to OSA patients because of its more precise information to upper airway obstruction.

Management of Obstructive Sleep Apnea.

Obstructive Sleep Apnea (OSA) is an important public health problem and is associated with considerable morbidity and mortality. Therefore, treatment of this condition is of paramount importance. The treatment of OSA includes general and behavioural measures, mechanical measures including continuous positive airway pressure (CPAP), Bilevel positive airway pressure (BiPAP) and Oral Appliances (OA), pharmacological treatment and surgical procedures. Continuous positive airway pressure (CPAP) treatment reverses the repetitive upper airway obstruction of sleep apnea and associated daytime sleepiness and is the most effective treatment for OSA. However maintaining patient adherence to CPAP therapy is a challenge. Weight loss should be recommended to overweight patients with OSA, as it has been shown that weight reduction has additional health benefits. Treatment of underlying medical conditions such as hypothyroidism or acromegaly has profound effect on apnea/hypopnea index. A subset of patients with OSA may benefit from supplemental oxygen and positional therapy. Presently, there are no effective pharmacotherapeutic agents for treatment of patients with OSA and the role of surgical treatment in OSA is controversial. However, pharmacological treatment of persisting residual sleepiness, despite adequate positive airway pressure therapy delivery and adherence, is indicated and may improve daytime sleepiness.

Resonance Characteristics of Pre-and Post -UPPP Operation in Patients with OSAHS / 听力学及言语疾病杂志

Objective To study the influence of UPPP on resonance characteristics of four resonance cavity in patients with OSAHS .Methods Using multi-channel voice analysis system to test the cavity resonance character-istics and energy distribution of 36 OSAHS patients (including pre - and post -operative) and 36 normal males when they speak /a:/.The frequency spectrum was 4 000Hz(FR1 ,FR2 ,FR3 ,FR4 ) .Results FR2 energy values of the head cavity and mouth cavity of OSAHS patients heighten significantly after UPPP (P<0 .05);FR1 energy val-ues of head ,mouth and thoracic cavity were higher than that of in normal males'after UPPP(P<0 .05) .FR2 ,FR3 , FR4 energy values of head cavity ,FR2 ,FR3 energy values of mouth cavity ,FR2 energy values of thoracic cavity were lower than those of in normal males'after UPPP(P<0 .05) .Conclusion UPPP surgery removes the obstruction of the upper airway of OSAHS patients and changes the morphology of the pharynx ,thas changes the resonance charac-teristics of the head cavity and oral .

The selection of surgical technique of coblation on the treatment of type Ⅱ obstructive sleep hypopnea apnea syndrome / 中国医师进修杂志

Objective To explore the therapeutic effect of Han-uvulopalatopharyngoplasty (H-UPPP) combined with coblation on treatment of type Ⅱ mild and moderate obstructive sleep apnea hypopnea syndrome (OSAHS).Methods According to the measuring parameters analyzed and clinical characteristics of velopharyngeal,68 patients were divided into 3 groups:group A (28 patients,treated by H-UPPP combined with coblation of tonsillectomy),group B (22 patients,treated by H-UPPP combined with drilling of tonsil) and group C (18 patients,treated by velopharyngeal multi-points drilling).After operation for 6 months,the pafor tients in 3 groups were detected by the polysomnography (PSG),Epworth sleepiness scale,and the parameters of velopharyngeal were compared.Results After operation for 6 months,the heal,excellence,efficiency and inefficiency patients in group A were 6,10,7,5 cases,in group B were 3,8,7,4 cases,in group C were 2,7,5,4 cases,there was no significant difference (P ＞0.05).After operation for 6 months,the apnea hyponea index (AHI) and the scores of ESS in group A,B,C were significantly lower than those before operation [(10.1 ± 2.3) times/h vs.(21.2 ± 2.5) times/h,(6.4 ± 1.0)scores vs.(16.2 ± 1.0) scores,(6.9 ± 1.3) times/h vs.(16.0 ± 1.4) times/h,(5.4 ± 1.3) scores vs.(14.5 ±1.5) scores,(7.7 ± 1.8) times/h vs.(16.0 ± 2.1) times/h,(4.1 ± 1.0) scores vs.(12.3 ± 1.9) scores],thelevel of LSaO2 was significantly higher (0.885 ±0.035 vs.0.737 ±0.030,0.871 ±0.046 vs.0.763 ±0.033,0.901 ±0.029 vs.0.820 ±0.034),there was significant difference (P ＜0.01),but there was no significant difference among 3 groups (P ＞ 0.05).After operation for 6 months,the pharyngomaxillary space,distance between uvula and posterior wall of pharynx,distance between anterior pillars in group A,B,C were significantly increased compared with those before operation [(24.6 ± 0.9) mm vs.(12.3 ± 1.2)mm,(11.6 ±1.2) mm vs.(5.4 ± 0.6) mm,(34.9 ± 1.2) mm vs.(28.3 ± 1.0) mm,(24.0 ± 0.8) mm vs.(14.3 ± 1.0) mm,(11.8 ± 0.8) mm vs.(6.3 ± 0.4) mm,(38.3 ± 0.8) mm vs.(31.9 ± 1.9) mm,(23.6 ± 1.4) mm vs.(19.9 ±1.1) mm,(7.3 ± 0.5) mm vs.(6.8 ± 0.6) mm,(38.5 ± 0.8) mm vs.(35.2 ± 1.0) mm],the length of soft palate was decreased [(31.9±0.9) mm vs.(38.3 ±0.9) mm,(25.6 ± 1.0) mm vs.(35.6 ± 1.2) mm,(29.9 ± 1.3) mm vs.(34.9 ±0.9) mtm],there was significant difference (P ＜0.01),but there was no significant difference among 3 groups (P ＞ 0.05).Conclusions H-UPPP combined with coblation on treatment of type Ⅱ mild and moderate OSAHS is effective and safe.According to the clinical characteristics of the patients to select suitable method is the key to get a satisfactory curative effect.

Surgical treatment of snoring & obstructive sleep apnoea.

Obstructive sleep apnoea (OSA) syndrome is a potentially serious disorder affecting millions of people around the world. Many of these individuals are undiagnosed while those who are diagnosed, often exhibit poor compliance with nightly use of continuous positive airway pressure (CPAP), a very effective nonsurgical treatment. Various surgical procedures have been proposed to manage and, in some cases, treat OSA. In this article we review methods used to assess the sites of obstruction and a number of surgical procedures designed to address OSA. Effective surgical management of OSA depends upon developing a complete database and determining different levels of obstruction, which may include nasal, nasopharyngeal, oropharyngeal, and hypopharyngeal/retrolingual, or a combination of these sites. A systematic approach to clinical evaluation, treatment planning and surgical management is recommended and is likely to result in more predictable outcomes. Surgical treatment may involve various procedures that are performed in different stages depending on the patient’s sites of obstruction. The most commonly performed procedures include nasal reconstruction, uvulopalatopharyngoplasty (UPPP), advancement genioplasty, mandibular osteotomy with genioglossus advancement, and hyoid myotomy and suspension. In more severe cases, maxillomandibular advancement (MMA) with advancement genioplasty may be indicated. Even after appropriate surgical treatment, some patients may demonstrate continued obstruction with associated symptoms. Published indications for surgical treatment include an elevated respiratory disturbance index (RDI) with excessive daytime somnolence (EDS), oxygen desaturations below 90 per cent, medical co-morbidities including hypertension and arrhythmias, anatomic abnormalities of the upper airway and failure of medical treatment. The success of surgery in OSA is generally measured by achieving a (RDI) of less than 5, improvement of oxygen nadir to 90 per cent or more with no desaturations below 90 per cent and quality of life improvements with elimination or significant reduction of OSA symptoms. From a practical point of view, achieving these goals may be extremely difficult without patients’ cooperation, most notably in the realm of weight loss and maintenance of a healthy lifestyle.

The Effect of Uvula-Preserving Palatopharyngoplasty in Obstructive Sleep Apnea on Globus Sense and Positional Dependency

OBJECTIVES: This study investigated the outcomes of uvula-preserving palatopharyngoplasty (UPPPP) in patients with obstructive sleep apnea syndrome (OSAS). METHODS: Twenty men with obstructive sleep apnea syndrome received the UPPPP operation at our institution. We measured symptom changes after UPPPP using a visual analog scale (VAS), and all patients were examined with polysomnography pre- and post-operatively. 'Surgical success' was defined as reduction in apnea-hypopnea index (AHI) to below 20 events per hour and more than 50% post-operative reduction. RESULTS: Snoring decreased significantly (6.7+/-2.3 to 3.7+/-2.9 on VAS, P=0.002) but the postoperative globus sense did not differ from that preoperatively (2.0+/-2.4 to 2.1+/-2.7 on VAS, P=0.79). Apnea and apnea-hypopnea indices were significantly reduced after UPPPP (34.7+/-20 to 24.2+/-17.2 events/hour, P=0.029). The surgical success rate was 40% regardless of Friedman stage. There was significant reduction in the AHI on supine sleep in both surgically successful and unsuccessful patient groups. CONCLUSION: UPPPP may minimize postoperative globus sense and other complications, with a success rate comparable to that of previously reported surgical methods in OSAS patients. In addition, it may reduce the apnea-hypopnea index in the supine sleep position.

The effect of uvulopalatopharyngoplasty by radio frequency plasma / 临床耳鼻咽喉头颈外科杂志

Objective:To study the effect of uvulopalatopharyngoplasty(UPPP) by using radio frequency plasma on obstructive sleep apnea-hypopnea syndrome(OSAHS) with Velopharyngeal obstruction.Method:Eighty-one cases that were diagnosed as OSAHS with Velopharyngeal obstruction were randomized into two groups, UPPP group and radio frequency plasma Velopharynoplasty group. Result:Six months after operation, the effects in both groups were similar.Conclusion:Radio frequency plasma Uvulopalatopharyngoplasty is safe, time saving, less hemorrhage with good effects.

Voicing Changes of Adult Patients with Obstructive Sleep Apnea hypopnea Syndrome (OSAHS) after H- uvulopalatopharyngoplasty (H- UPPP) / 听力学及言语疾病杂志

Objective To investigate voicing changes of adult patients with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after H-uvulopalatopharyngoplasty (H-UPPP). Methods 56 adult OSAHS pa-tients and 40 healthy people were included in the study. Acoustic parameters and formant frequencies were measured for each patient before and after H- UPPP, and also for the control group. Results Acoustic parameters: each group demonstrated no differences in all the parameters except for normalized noised energy (NNE). NNE increased after H-UPPP. Formant frequency: F1, B1, F2, B2, F3 of OSAHS patients were significantly lower than normal control. There was no significant difference in the formant frequency before operation and one week after; however, F1 and F2 were lower than the normal control one week after surgery. One month after surgery, F1 and F2 were ob-viously higher than that obtained in one week. All the other parameters compared with normal controls showed no significant discrepancies. Conclusion Acoustic characteristics of adult OSAHS patients were different from healthy person. After H-UPPP, the vocal tracts of patients changed, thus causing improvement to the acoustic parameters and voicing qualities, especially at the formant frequency. After the surgery, the formant frequencies of the patients increased gradually to the range of healthy people.

Changes of Taste Function after Palatopharyngeal Surgery in Obstructive Sleep Apnea Syndrome / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Postoperative taste changes after uvulopalatopharyngoplasty (UPPP) is regarded as an unusual and minor complication. This study aims to evaluate the objective changes of taste threshold according to time course and subjective symptoms change. MATERIALS AND METHOD: With 45 patients who underwent UPPP and 35 patients who underwent nasal surgery as control group, we have prospectively studied postoperative taste changes using a questionnaire, and an electrogustometer (EGM) with regard to symptoms at 7th, 28th days after the surgery. EGM was measured at 5 areas. Also, we have checked pre-operatively about the serum level of zinc. RESULTS: With EGM, the threshold of taste was increased at 7th days after the surgery (p<0.05), but recovered 28th days after the surgery at the posterior part of the tongue in the UPPP group. There were no significant changes in subjective taste dysfunction, smell dysfunction, tongue sensory abnormality, and dysgeusia. CONCLUSION: Taste changes after UPPP was transient and they disappeared within the 1st postoperative month. There were no patients who complained of subjective taste dysfunction, dysgeusia, tongue sensory abnormality after UPPP.