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Surgery for obstructive sleep apnoea.

S Sundaram1, S A Bridgman, J Lim

  • 1Norfolk & Norwich University Hospital, Norwich, Norfolk, UK. supriya.sundaram@nnuh.nhs.uk

The Cochrane Database of Systematic Reviews
|October 20, 2005
PubMed
Summary
This summary is machine-generated.

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Surgery for obstructive sleep apnoea/hypopnoea syndrome (OSAHS) shows no significant overall benefit. More long-term studies are needed to determine if surgical interventions are curative or if symptoms re-emerge.

Area of Science:

  • Otolaryngology
  • Sleep Medicine
  • Surgical Innovation

Background:

  • Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is characterized by periodic airflow cessation during sleep, leading to snoring, disrupted sleep, and daytime sleepiness.
  • Surgical interventions for OSAHS aim to reduce symptoms, improve sleep quality, and decrease polysomnographic signs of sleep apnoea.

Purpose of the Study:

  • To systematically review the efficacy of various surgical treatments for adult obstructive sleep apnoea/hypopnoea syndrome.
  • To compare surgical interventions against other surgical or non-surgical approaches, including no intervention.

Main Methods:

  • Searched the Cochrane Airways Group Specialised Register and relevant literature up to July 2005.
  • Included randomized controlled trials comparing any surgical intervention for OSAHS with control treatments.

Related Experiment Videos

  • Two reviewers extracted data from eligible studies.

    • Main Results:

    • Eight studies (412 participants) met inclusion criteria; data from seven were analyzed.
    • Uvulopalatopharyngoplasty (UPPP) showed no significant polysomnographic differences versus conservative management.
    • Laser-assisted uvulopalatoplasty (LAUP) showed mixed results, with one study reporting improved apnoea-hypopnoea index (AHI) and snoring, but no quality of life improvements.
    • Oral appliances demonstrated a lower AHI than UPPP.
    • Lateral pharyngoplasty showed a greater AHI reduction than UPPP.
    • Tongue advancement and tongue suspension techniques showed similar symptom reduction.
    • Radiofrequency tissue ablation showed improvement over sham but no difference compared to CPAP.
    • Complications like nasal regurgitation, pain, and bleeding were temporary.

    Conclusions:

    • Current evidence from available trials does not conclusively support the use of surgery for OSAHS due to a lack of demonstrated significant overall benefit.
    • Participants often present with moderate daytime sleepiness, but short-term outcomes are insufficient for selecting surgical candidates.
    • Long-term follow-up is crucial to assess if surgical correction provides a cure or if OSAHS symptoms tend to recur.