[Surgical therapy of obstructive sleep apnea syndromes: results of the Ulm treatment program]

The article reports on the results obtained by uvulopalatopharyngoplastic surgery (= UPPPS) in 31 patients suffering from obstructive sleep apnoea syndrome (= OSAS) and in 9 patients with habitual or obstructive snoring. All patients were subjected to thorough preoperative examination including rhinometry, nasopharyngeal video-endoscopy, radiocephalometry and polysomnography. In 8 out of 9 (89%) of the habitually snoring patients and in 17 of 31 (55%) of OSAS patients, surgery was successful. In these patients, a postoperative respiratory disturbance index (RDI) of less than 10 was recorded, whereas in 4 patients (13%) the postoperative RDI was between 10 and 15. Ten patients did not respond satisfactorily to UPPPS (32%). RDI was postoperatively still above 15. Analysis of patient data shows that almost all habitually snoring patients and the OSAS patients with slight overweight and low to medium apnoea index were successfully treated with UPPPS. In accordance with these results a treatment concept has been drawn up for OSAS patients that takes stock of all the possibilities and limitations of available conservative and surgical treatment methods.