Related Experiment Videos
Combination surgical and mechanical therapy for refractory cases of obstructive sleep apnea
Robert Seemann1, John C DiToppa, Mary-Ann Holm
1Department of Surgery, Division of Otolaryngology, University of Alberta, Edmonton, Alberta.
Objective:
Our purpose was to investigate the effects of surgical alteration of the soft palate by laser-assisted uvulopalatoplasty (LAUP) on the effectiveness of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea. Specifically, is there any change in effective CPAP pressure after LAUP?
Design:
Ten patients from a group of LAUP candidates who either failed LAUP treatment as measured by pre- and postpolysomnography or were unable to tolerate CPAP were prospectively evaluated.
Patients:
Fifty patients were referred to an otolaryngologist for evaluation and treatment of obstructive sleep apnea. Forty-three had LAUP surgery. Five patients had failed LAUP therapy and another five were unable to tolerate CPAP prior to LAUP.
Methods:
Polysomnography was used to evaluate patients pre- and postoperatively. Polysomnography with CPAP titration was then used to compare the effects of LAUP in combination with CPAP.
Results:
The average, effective CPAP decreased by 4.8 cm H2O after LAUP. In patients who failed LAUP therapy, CPAP was still found to be effective.