Please use this identifier to cite or link to this item: http://ir.swu.ac.th/jspui/handle/123456789/14681
Title: Palatal suspension and uvulopalatopharyngoplasty for obstructive sleep apnea
Authors: Neruntarat C.
Chantapant S.
Keywords: suture material
adult
airway obstruction
article
bleeding
clinical protocol
clinical trial
comparative study
controlled clinical trial
controlled study
demography
disease severity
drug efficacy
excision
follow up
human
infection
major clinical study
operation duration
oral surgery
oxygen saturation
palatal suspension
palate
polysomnography
postoperative care
postoperative pain
preoperative evaluation
prospective study
randomized controlled trial
REM sleep
scoring system
sleep apnea syndrome
sleep stage
snoring
soft palate
surgical technique
uvulopalatopharyngoplasty
visual analog scale
Issue Date: 2010
Abstract: Objective: Uvulopalatopharyngoplasty (UPPP) in the treatment of obstructive sleep apnea (OSA) is to enlarge the retropalatal airway by excision of the uvula and posterior portion of the palate. Successful subjective and objective results have been reported, however postoperative pain is severe. Palatal suspension (PS) was developed to open the retropalatal airway without removal of palatal tissue. It anchored the soft palate to the anterior hard palate and enlarged the airway space. The purpose of this study was to compare the efficacy of PS and UPPP in the treatment of OSA patients with palatal obstruction. Materials and Methods: Fifty one patients with OSA and palatal airway obstruction were prospectively enrolled into a randomized, surgical protocol. A comparison of the demographic parameters and disease severity showed that the PS group and the UPPP group were similar. The mean follow-up time was about 3 months. Data on the patients were compared from the preoperative to postoperative assessments and between the groups. Results: In PS group, the AHI decreased from a mean of 39.8 ± 4.9 to 19.4 ± 5.9 (p < 0.01), ESS decreased from a mean of 12.8 ± 3.8 to 6.6 ± 2.9 (p < 0.001), and VAS for snoring decreased from 8.7 ± 1.2 to 3.5 ± 2.3 (p < 0.01). In UPPP group, the AHI decreased from a mean of 40.2 ± 5.8 to 19.8 ± 6.1 (p < 0.001), ESS decreased from a mean of 13.1 ± 4.3 to 6.8 ± 3.1 (p < 0.001), and VAS for snoring decreased from 8.8 ± 0.8 to 3.2 ± 2.3 (p < 0.01). The change scores in patients who underwent PS and UPPP were not of significant difference. Based on the criteria for success that the AHI decreased more than 50% from the baseline and the final AHI was less than twenty, 64% (15 of 25) of PS patients and 65.4% (17 of 26) of UPPP patients achieved a surgical success (p = 0.71). There was statistically significant difference in the first week for postoperative pain between PS and UPPP (6.8 ± 2.2 vs 8.8 ± 2.4, p < 0.001). The mean operative time and blood loss for PS and UPPP were of significant difference (20.8 ± 5.2 minutes vs 30.2 ± 6.2 minutes, p < 0.05 and 10.2 ± 10.5 ml vs 30.8 ± 10.7 ml, p < 0.001). Bleeding, airway obstruction, infection, and extrusion of suture material were not encountered. Conclusion: Palatal suspension is a simple and effective procedure. It can be performed in carefully selected OSA patients with low chance of pain and complications when compares with UPPP. © 2010 Japan International Cultural Exchange Foundation.
URI: https://www.scopus.com/inward/record.uri?eid=2-s2.0-77957007029&partnerID=40&md5=e021c18ea8615b0df660028b6a49085e
http://ir.swu.ac.th/jspui/handle/123456789/14681
ISSN: 13412051
Appears in Collections:Scopus 1983-2021

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