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Updated: Jul 20, 2026
07:54
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Oropharyngeal surgery for obstructive sleep apnoea in CPAP failures
Edward Chisholm1, Bhik Kotecha
1Royal National Throat Nose and Ear Hospital, 330/332 Grays Inn Road, London, WC1X 8DA, UK.
Summary
Laser assisted uvulopalatoplasty (LAUP) effectively reduces obstructive sleep apnea (OSA) severity in patients intolerant to continuous positive airway pressure (CPAP). Careful patient selection based on obstruction level is key to LAUP
Area of Science:
- Otolaryngology
- Sleep Medicine
- Surgical Innovation
Background:
- Continuous positive airway pressure (CPAP) is effective for moderate-to-severe obstructive sleep apnea (OSA) but often poorly tolerated.
- Alternative treatments are needed for patients who cannot tolerate CPAP therapy.
Purpose of the Study:
- To evaluate the efficacy of laser assisted uvulopalatoplasty (LAUP) in patients with moderate-to-severe OSA who are intolerant of CPAP.
- To assess the impact of LAUP on apnea-hypopnea index (AHI) and daytime sleepiness.
Main Methods:
- Dynamic sleep nasendoscopy was used to identify the anatomical level of obstruction and patient suitability for LAUP.
- Twenty patients with moderate-to-severe OSA and CPAP intolerance were included.
- Pre- and post-operative polysomnography and Epworth sleepiness scores were compared.
Main Results:
- Mean AHI decreased by 73% from 47.9 to 12.9 events per hour post-LAUP.
- Mean Epworth sleepiness scores reduced by 7.9 points.
- Two patients required reduced CPAP pressure post-procedure; no significant weight loss occurred.
Conclusions:
- LAUP is an effective treatment for reducing OSA severity in CPAP-intolerant patients.
- Careful patient selection based on anatomical obstruction level is crucial for successful LAUP outcomes.
- Findings contrast with some previous reviews, highlighting the importance of patient selection criteria.
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