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Effects of uvulopalatopharyngoplasty: a seven year review
W H Aneeza1, M B Marina, M Y Razif
1Department of Otorhinolaryngology and Head & Neck Surgery, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia.
Insights
Uvulopalatopharyngoplasty (UPPP) effectively treats obstructive sleep apnea long-term, reducing sleepiness. However, 78.5% experienced side effects, necessitating consideration of uvula-preserving alternatives.
Area of Science:
- Otolaryngology
- Sleep Medicine
- Surgical Outcomes
Background:
- Obstructive sleep apnea syndrome (OSAS) significantly impacts patient quality of life.
- Uvulopalatopharyngoplasty (UPPP) is a common surgical intervention for OSAS.
- Long-term outcomes and side effects of UPPP require further investigation.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of Uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea syndrome (OSAS).
- To assess patient-reported outcomes, including sleepiness and side effects, after UPPP.
Main Methods:
- Retrospective review of 38 patients undergoing UPPP between July 2000 and December 2007.
- Long-term follow-up (1-7 years) of 14 patients, including Epworth Sleepiness Scale (ESS) scoring.
- Documentation of post-operative side effects and assessment of success defined by >50% reduction in apnea-hypopnea index (AHI).
Main Results:
- Uvulopalatopharyngoplasty (UPPP) demonstrated long-term success in 60% of patients.
- Mean Epworth Sleepiness Scale (ESS) scores significantly decreased from 12 +/- 6 to 7 +/- 4.
- Long-term side effects were reported by 78.5% of patients, with velopharyngeal insufficiency being the most common (42.8%).
Conclusions:
- Uvulopalatopharyngoplasty (UPPP) provides effective long-term symptom improvement for obstructive sleep apnea syndrome (OSAS).
- The high incidence of long-term side effects associated with UPPP warrants consideration of alternative surgical approaches.
- Uvula-preserving surgeries should be explored as viable options to mitigate UPPP-related complications.
Abstract:
To review the long term outcome of Uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnoea syndrome in a tertiary referral centre. 38 records were traced where UPPP was done from July 2000 to December 2007. 14 patients were followed up for one to seven years where the Epworth sleepiness scale was scored, long term side effects documented and post operative muller's manoeuvre done. Success of UPPP is defined as a reduction in apnoea hypopnea index (AHI) more than 50%. Sixty percent (60%) were successfully treated with UPPP in the long term. Mean ESS was significantly reduced from 12 +/- 6 to 7 +/- 4. 11 out of 14 patients (78.5%) were reported to develop long term side effects of UPPP, the highest being velopharyngeal insufficiency (42.8%). In conclusion, UPPP is effective in improving symptoms of OSA in the long term. However, in view of its side effects, uvula preserving surgery should be considered as a surgical option.
