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Effect of surgery on obstructive sleep apnea
T Nishimura1, N Morishima, S Hasegawa
1ENT Department of Fujita Health University Second Hospital, Nagoya, Japan.
Insights
Surgical interventions for sleep apnea syndrome significantly improved outcomes in children and adults. Adenotonsillectomy was effective for children, while adults saw varied results with UPPP, MLG, and nasal surgeries.
Area of Science:
- Otolaryngology
- Sleep Medicine
- Surgical Outcomes
Background:
- Sleep apnea syndrome presents with snoring and related symptoms.
- Surgical treatment is a common intervention for sleep apnea syndrome.
- Evaluating surgical efficacy requires objective measures like the Apnea-Hypopnea Index (AHI).
Purpose of the Study:
- To statistically analyze the pre- and post-operative outcomes of patients treated surgically for sleep apnea syndrome.
- To assess the effectiveness of different surgical procedures in children and adults.
Main Methods:
- A retrospective analysis of 149 patients (55 children, 94 adults) treated over three years.
- Children underwent adenotonsillectomy; adults received uvulopalatopharyngoplasty (UPPP), midline laser glossectomy (MLG), and/or nasal surgery.
- Outcomes were measured by changes in the Apnea-Hypopnea Index (AHI), with defined criteria for marked improvement, improvement, slight improvement, and no improvement.
Main Results:
- In children with AHI > 5, 86% showed marked improvement post-adenotonsillectomy.
- In adults, 48% demonstrated marked improvement after UPPP, MLG, and/or nasal surgery.
- Significant improvement rates varied, with 21% of adults showing no improvement.
Conclusions:
- Surgical treatment, particularly adenotonsillectomy, is highly effective for improving sleep apnea syndrome in children.
- Surgical outcomes in adults are more variable, suggesting the need for tailored treatment approaches.
- Further research may explore factors influencing adult surgical success rates in sleep apnea syndrome.
Abstract:
The statistical analysis of data obtained by monitoring pre- and post-operative conditions of patients treated for sleep apnea syndrome is reported. In the past 3 years, surgery was performed on 149 patients (55 children and 94 adults), who complained of snoring and symptoms related to the sleep apnea syndrome at Fujita Health University, The Second Hospital. Treatment for children was adeno-tonsillectomy. Treatment for adults was uvulo-palato-pharyngoplasty (UPPP), midline laser glossectomy (MLG) and/or nasal surgery. Apnea hypopnea index was defined as frequency of apnea hypopnea per hour. Pathological apnea (sleep apnea syndrome) was defined as apnea hypopnea (AHI) 10 in adults and AHI 5 in children. Marked improvement was defined as 75% reduction in AHI or a postoperative AHI below 10 in adults and 5 in children. Improvement was defined as 50-74% reduction of AHI. Slight improvement was defined as 25-49% reduction of AHI. No improvement was defined as less than 25% reduction of AHI. Of these 55 children, the AHI of 35 of them was above 5. Thirty cases (86%) showed marked improvement after treatment; 3 cases (8%) showed improvement; 1 case (3%) slight improvement and 1 case (3%) no improvement. Of these 94 adults, 40 cases (48%) showed marked improvement after treatment; 12 cases (14%) showed improvement; 14 cases (17%) slight improvement and 18 cases (21%) no improvement at all.