Hypopharyngeal Airway Surgery for Obstructive Sleep Apnea: Morbidity in the Early Postoperative Period

To determine if hypopharyngeal surgery for obstructive sleep apnea is associated with significant morbidity in the early post-operative period.

Patients with a diagnosis of obstructive sleep apnea who underwent hypopharyngeal surgery at a tertiary care facility between November 2012 and September 2013 were included in this study. Surgical outcomes were assessed from medical records review and a 14 question telephone survey. Results: Twenty-two patients underwent hypopharyngeal surgery for obstructive sleep apnea (OSA). No patient experienced intra-operative complications, post-operative O2 desaturation <90%, prolonged admission for inadequate pain control, pulmonary edema, or airway compromise requiring re-intubation. Post-operative complications included one episode of nasal hemorrhage, one infection requiring hospitalization, and one episode of dehydration treated with IV fluids. 25% of patients experienced some degree of post-operative dysphonia, and 87.5% of patients experienced post-operative dysphagia. The average rating for post-operative pharyngeal pain was 3.5 of 10 by week 3 and 1.75 of 10 by week 4. Most patients described decreased snoring (93.75%), improved feeling of overall health (75%), and increased daytime energy (62.5%). All patients undergoing hypopharyngeal airway surgery were discharged within 23 hours.

Hypopharyngeal surgery is a safe and well tolerated procedure for the treatment of OSA. Our findings suggest that hypopharyngeal surgery may be performed on an outpatient basis.