Comparation between modified coblation assisted uvulopalatopharyngoplasty and conventional uvulopalatopharyngoplasty in operative complication / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To compare the operative effectivity and incidence of postoperative complication between conventional uvulopalatopharyngoplasty (UPPP) and modified coblation assisted UPPP (M-CAUP) in treating patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). And to explore the more effective, safer and minimally invasive operative method in surgical therapy of OSAHS.</p><p><b>METHODS</b>It was a controlled trial. A retrospective analysis was made on surgical complications of conventional UPPP and of M-CAUP performed on OSAHS patients from 1995 to 2010. There were 451 patients in UPPP group and 323 patients in M-CAUP group. χ(2) test and Fisher's Exact test were used in statistical analysis.</p><p><b>RESULTS</b>The incidence of serious surgical complications was higher in conventional UPPP group (3.77%, 17/451) than that in M-CAUP group (0.62%, 2/323), χ(2) = 7.800, P < 0.01, while the incidence of short-term complications was higher in M-CAUP group (90.40%, 292/323) than that in conventional UPPP group (60.98%, 275/451), χ(2) = 83.186, P < 0.01. The difference of long-term complications was not statistically significant between M-CAUP group and conventional UPPP group (P = 0.1331, Fisher Exact test). There was no significant difference in incidence of asphyxia between M-CAUP group and conventional UPPP group (P < 0.01, Fisher Exact test). However, the incidence of post-operative primary hemorrhage was obviously lower in M-CAUP group than that in conventional UPPP group (3.99%, 18/451), χ(2) = 12.133, P < 0.01. While the incidence of delayed hemorrhage, temporal velopharyngeal insufficiency, and foreign body sensation at pharynx were higher in M-CAUP group (8.05%, 12.69%, 68.42%, respectively) than that in conventional UPPP group (3.77%, 3.33%, 51.00%, respectively) P < 0.01, respectively. There was no significant difference in incidence of permanent velopharyngeal insufficiency, stenosis of nasopharynx and nasopharyngeal atresia, alteration of taste, throat itch and coughing.</p><p><b>CONCLUSION</b>Compared to the conventional UPPP, M-CAUP was more effective and safer in treating OSAHS with less severe complications during and after the operation.</p>