Continuous pressure measurements in the evaluation of patients for laser assisted uvulopalatoplasty

The aim of the present study was to evaluate the effect of laser-assisted uvulopalatoplasty (LUPP) performed under local anesthesia in an outpatient setting. No procedure included tonsillectomy. Obstruction related mainly to the velopharyngeal segment of the airway was defined in 16 consecutive patients by clinical examination, nocturnal polysomnography and pressure measurements. The mean follow-up period was 7 months, range 3-16 months. Using five pressure sensors, four separate upper airway segments could be defined. The preoperative location of obstructive segments in obstructive apneas was proximal and was identified in the velopharyngeal segments in 90% of the patients. This was the case in 92% of the patients with hypopneas. After LUPP, there were statistically significant improvements in the duration of respiratory events (P < 0.02), incidence of sleep with snoring (P < 0.001), apnea-hypopnea index (P < 0.01), microarousal index (P < 0.02) and the mean duration of non-rapid eye movement sleep with oxygen saturation < 80% (P < 0.0001). Four patients still had proximal obstructions after LUPP, but these were clinically tolerable.