Uvulopalatal flap for snoring on an outpatient basis

Abstract

OBJECTIVE: Snoring is now seen as one end of a spectrum of sleep-related breathing disorders, and in its extreme form, snoring can cause obstructive sleep apnea syndrome. Since the introduction of uvulopalatopharyngoplasty, many other procedures have been introduced to alleviate palatal abnormalities seen in patients with obstructive sleep apnea syndrome. A reversible uvulopalatal flap (UPF) achieves the same results as the uvulopalatopharyngoplasty but with less postoperative discomfort. The purpose of this study was to assess the safety and efficacy of UPF for the treatment of simple snoring on an outpatient basis. METHODS: UFP was performed on an outpatient basis under local anesthesia. The mucosa on the lingual surface of the uvula and soft palate was removed with cold knife dissection. The uvular tip was amputated. The uvula was reflected back toward the soft palate and sutured. Most of the patients were male with simple snoring by history and confirmed by polysomnographic study. Data on patients were compared from preoperative to postoperative assessment points. Statistic analysis was performed. RESULTS: Fifty-six patients tolerated the procedure well, and it was performed in an average of 20 minutes. Patients had a mean age of 48 years and a mean body mass index of 26.5 kg/m2. The mean follow-up was 14 months (range, 12 to 20 months). Significant improvement was observed in snoring scale (8.2 ± 3.4 versus 2.6 ± 1.4, P < 0.05). Mean snoring index decreased from 245.8 ± 40.8 to 42. 5 ± 20.7 events/hr (P < 0.001). The correlations between the changes in the subjective and objective snoring assessments were statistically significant. Postoperative complications included transient nasal regurgitation (4%) and foreign body sensation (2%). Bleeding, dysphagia, infection, and nasopharyngeal stenosis were not observed. Most patients had mild to moderate pain (visual analog scale, ≤7) for 5 to 7 days after the procedures. The overall success rate was 88%. CONCLUSION: Snoring, as reported by subjective and objective results, decreased after UPF. It appears to be a safe and effective procedure, which can be easily performed under local anesthesia on an outpatient basis, in carefully selected patients.