Patient-Reported Outcomes of Palatopharyngeal Surgery Without Tonsillectomy: A Meta-Analysis

Area of Science:

• Otolaryngology
• Sleep Medicine
• Surgical Outcomes Research

Background:

• Obstructive sleep apnea (OSA) and snoring significantly impact quality of life.
• Patient-reported outcome measures (PROMs) are crucial for evaluating surgical success.
• Palatopharyngeal surgical modifications without tonsillectomy are explored as treatment options.

Purpose of the Study:

• To compare PROMs across various palatopharyngeal surgical techniques for snoring and OSA.
• To evaluate the effectiveness of different surgical approaches in improving daytime sleepiness and snoring intensity.
• To identify which surgical modifications yield the best patient-reported results without tonsillectomy.

Main Methods:

• Systematic review and meta-analysis of original studies.
• Inclusion of adult patients undergoing palatopharyngeal surgery without tonsillectomy.
• Primary PROMs: Epworth Sleepiness Scale (ESS) for sleepiness and visual analog scale for snoring intensity.

Main Results:

• Fifty-five studies with 1815 patients were analyzed.
• Overall reduction in ESS by 3.3 points and snoring intensity by 4.1 points.
• Suture palatopharyngoplasty, muscle relocation, cold-steel, and powered instruments demonstrated superior outcomes.

Conclusions:

• Palatopharyngeal surgery without tonsillectomy is effective for improving daytime sleepiness and snoring.
• Surgical technique significantly influences patient-reported outcomes.
• Findings aid in surgical planning and patient counseling for OSA and snoring.