Obstructive sleep apnea syndrome: preoperative radiologic evaluation

The purpose of this study was to determine whether lateral radiographs of the pharynx and fluoroscopy of the lateral pharynx in the sleeping patient could be used as predictors of surgical success in patients undergoing soft-palate surgery for obstructive sleep apnea. A total of 12 patients had surgery after radiologic evaluation. There were six surgical successes and six failures. No successes occurred in patients with a soft-palate length of less than 46 mm, nor were there any successes among patients whose initial point of obstruction on fluoroscopy was inferior to the level of the soft palate. There was one surgical failure among patients in whom fluoroscopy showed upper airway obstruction beginning at the level of the soft palate during sleep. Results suggest that a patient is most likely to benefit from soft-palate resection if the soft palate is long--we conservatively suggest greater than 40 mm--and if sleep fluoroscopy of the lateral pharynx shows airway obstruction beginning at the level of the soft palate.