Related Experiment Video
Updated: May 8, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Theoretical approach towards increasing effectiveness of palatal surgery in obstructive sleep apnea: role for
J P van Maanen1, B I Witte, N de Vries
1Department of Otolaryngology/Head Neck Surgery, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands, p.vanmaanen@slaz.nl.
Purpose:
The aims of this study are to evaluate the effect of palatal surgery (uvulopalatopharyngoplasty (UPPP) or Z-palatoplasty (ZPP)) with or without (+/-) concomitant radiofrequent ablation of the base of the tongue (RFTB) on body position-specific apnea-hypopnea index (AHI) values in patients with obstructive sleep apnea (OSA) and to compare this treatment outcome to the theoretical effect of (addition of) positional therapy (PT).
Methods:
Retrospective analysis of pre- and posttreatment polysomnographies in 139 patients who had undergone UPPP/ZPP +/- RFTB was performed. Hypothetical evaluation of the effects of (addition of) ideal PT on AHI in positional OSA (POSA) patients was carried out.
Results:
Median AHI significantly decreased from 18.0 to 11.2 (p < 0.001). Median AHI in all separate positions decreased significantly as well. Sixty-eight patients suffered from POSA and showed a significant decrease in median AHI from 15.5 to 11.5 (p = 0.002). In the 71 non-positional OSA (NPOSA) patients, the significant AHI decrease was more outspoken, from 23.0 to 11.0 (p < 0.001). Our hypothetical model to treat POSA patients with an ideal PT (as monotherapy or in addition to surgery) resulted in a significant median AHI decrease from 18.0 to 4.5 (p < 0.0001).
Conclusions:
UPPP/ZPP +/- RFTB significantly reduces AHI and all body position-specific AHI values. This reduction is significantly higher in NPOSA than in POSA patients. When considering UPPP/ZPP +/- RFTB, the effect of body position needs to be taken into account. PT, either as monotherapy or in addition to surgery, theoretically has shown to improve treatment results dramatically in POSA patients. Prospective, controlled trials focusing on the effects of this combination of treatments should further evaluate this hypothetical conclusion.
Related Concept Videos
Cardiopulmonary Resuscitation II: ACLS Airway Management
Sleep Apnea
The condition is more prevalent among...
Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation (NIPPV)
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue, improving...
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
