Quality-of-life outcomes before and after multilevel pharyngeal surgery in moderate-to-severe obstructive sleep apnea

To assess changes in subjective quality of life (dizziness, tinnitus, sleep quality, daytime sleepiness) in moderate-to-severe obstructive sleep apnea patients before and after multilevel pharyngeal surgery (uvulopalatopharyngoplasty, bilateral tonsillectomy and tongue-base radiofrequency ablation), and identify the main factors influencing postoperative outcomes.

Thirty-one OSA patients diagnosed via Polysomnography (PSG) underwent preoperative bilateral bithermal caloric testing and completed the Dizziness Handicap Inventory (DHI), Tinnitus Handicap Inventory (THI), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Assessments were repeated 6-months postoperatively. Pairedt-tests compared pre/post scores, and multiple linear regression identified factors affecting quality of life.

Our analysis revealed three major findings: (1) Canal Paresis (CP) was not correlated with DHI scores; (2) Postoperative DHI, THI, PSQI, and ESS scores significantly decreased (p ≤ 0.05). The 95% confidence intervals for the differences were 2.396-8.830, 0.773-3.356, 2.835-4.907, and 3.376-7.140, respectively; (3) Apnea-Hypopnea Index (AHI) and Lowest Oxygen Saturation (LSpO₂) were primary determinants of postoperative quality of life. AHI and LSpO₂ strongly negatively correlated with postoperative DHI (βAHI = -0.604, βLSpO₂ = -0.485) and PSQI scores (βLSpO₂ = -0.656, βAHI = -0.384).

The subjective quality of life in moderate to severe OSA patients, particularly for dizziness, tinnitus, sleep quality, and daytime sleepiness, was significantly improved after surgical treatment. In terms of postoperative quality of life, AHI and LSpO₂ were identified as the main factors. Higher preoperative AHI and lower LSpO₂ were associated with better postoperative outcomes.