OSAS and upper pharynx surgery: Does basilingual collapsus always rhyme with failure?

Area of Science:

• Otolaryngology
• Sleep Medicine
• Surgical Planning

Background:

• Drug-induced-sedation endoscopy (DISE) is superior to awake examination for diagnosing upper airway obstruction.
• Identifying multilevel obstruction via DISE raises questions about the efficacy of limited upper pharyngeal surgery.

Purpose of the Study:

• To determine if multilevel obstruction on DISE systematically leads to failure in patients undergoing surgery limited to the upper pharynx.

Main Methods:

• Retrospective study of 63 obstructive sleep apnea syndrome (OSAS) patients undergoing single-level upper pharynx surgery.
• Preoperative assessment included polysomnography (PSG) and DISE.
• Surgical efficacy evaluated by postoperative PSG, comparing patients with and without lower pharyngeal obstruction.

Main Results:

• No statistically significant difference in success or cure rates between patients with (Group B, n=27) and without (Group A, n=36) basilingual or laryngeal collapsus.
• Success rates were 66.7% in Group A and 59.3% in Group B.
• Cure rates were 48.5% in Group A and 48.1% in Group B.

Conclusions:

• Oropharyngeal surgery can successfully address obstructive sites in the lower pharynx identified by DISE.
• Step-by-step treatment approaches demonstrate efficacy comparable to single-step multilevel surgery for OSAS.