Clinical study of surgical treatments for snoring and obstructive sleep apnea

ABSTRACT

PURPOSE: Clinical study to evaluate the efficacy and the safety of various surgical treatments in snoring and obstructive sleep apnea. METHODS AND MATERIALS: We performed surgical treatments such as radiofrequency ablation, uvulopalatopharyngoplasty(UPPP) with tonsillectomy, uvulopalatopharyngoplasty with advancement genioplasty, orthognathic surgery(maxillomandibluar advancement), distraction osteogenesis device insertion. Diagnosis was performed with clinical examination, polysomnography, lateral cephalometric and computed tomography. 62(M : F = 45 :17 , mean age 41.5, mean follow-up 4 weeks) patients underwent radiofrequency ablation and 7(M : F = 5 : 2, mean age 38.9, mean follow-up 19months)patients experienced uvulopalatopharyngoplasty with tonsillectomy. Uvulopalatophayngoplasty with advancement genioplasty was performed for 3 (M : F = 2: 1, mean age 30.2 , mean follow-up 14 months)patients. The last 3(M : F = 2 : 1, mean age 21.5 , mean follow-up 24 months)patients was treated with orthognathic surgery including distraction device insertion. The results was evaluated by questionnaires, polysomnography, investigation of complications. RESULTS: Of the patients treated with radiofrequency ablation, 95% reported improvement of their symptom. 100% improvement was reported in patients treated with UPPP with tonsillectomy and UPPP with advancement genioplasty. The two of three patients who underwent orthognathic surgery showed the satisfactory of treatments. Dryness of mouth was the most common complication during short period in radiofrequency ablation and UPPP with tonsillectomy. Relapse complication was not found in any surgical treatments. CONCLUSION: Treatment for snoring and OSA is determined by severity degree of the physiologic derangements, predominant type of apnea and obstructive site. Accuracy diagnosis should be performed prior to treatment for satisfactory treatment result. This study demonstrates feasibility, safety and efficacy of surgical treatments in snoring and OSA.