Palatal and tongue base surgery for surgical treatment of obstructive sleep apnea: A prospective study

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OBJECTIVE:To assess the effect of concurrent uvulopalatopharyngoplasty (UPPP) and hypopharyngeal procedures in obstructive sleep apnea (OSA) patients with diffuse airway narrowing.STUDY DESIGN AND SETTING:Forty-eight patients were treated surgically by a single surgeon in private practice over 2 years. Symptoms, Epworth score, and polysomnographic outcome were assessed preoperatively and postoperatively. The Friedman staging system was applied. UPPP with genioglossus advancement, hyoid suspension, or radiofrequency treatment was carried out.RESULTS:In 37 patients with complete data, the average apnea-hypopnea index (AHI) was reduced from 46.5 ± 24.8 to 14.9 ± 16.8. The Epworth score was reduced from 12.1 ± 4.9 to 6.7 ± 3.7. Most patients reported improved sleep quality, alertness, memory, concentration, and mood.CONCLUSION:Successful outcome, defined by symptom and AHI reduction, was achieved with multilevel surgery for most patients with advanced Friedman stages 2 and 3.SIGNIFICANCE:Multilevel surgery seems effective in treating severe OSA patients with diffuse airway narrowing.EBM rating: C-4

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