Effect of Isolated Uvulopalatopharyngoplasty on Subjective Obstructive Sleep Apnea Symptoms
1
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Objectives. The aims of this study were 1) to evaluate the effect of isolated uvulopalatopharyngoplasty (UPPP) on subjective obstructive sleep apnea (OSA) symptoms in adult patients regardless of the response to surgery, and ultimately 2)to investigate the differences in changes in subjective OSA symptoms between successful and unsuccessful surgery groups. Methods. Twenty consecutive adult patients who underwent isolated UPPP were enrolled. Pre- and postoperative subjective OSA symptoms (snoring, witnessed apnea, daytime sleepiness, morning headache, daytime fatigue, restless sleep,difficulty with morning arousal) and polysomnographic data were evaluated in all subjects. Changes in subjective OSA symptoms before and after surgery were investigated in the successful (n=11) and unsuccessful (n=9) groups. Surgical success was defined as a reduction of at least 50% in the preoperative apnea-hypopnea index (AHI) and a postoperative AHI less than 20 per hour. Results. After isolated UPPP, all subjective OSA symptoms changed significantly in the patients, especially in the successful group. In the unsuccessful group, snoring, witnessed apnea and daytime fatigue changed significantly, while other symptoms did not change significantly after surgery. Conclusion. Isolated UPPP may improve subjective OSA symptoms in adult patients whom surgery was successful or unsuccessful. However, after isolated UPPP, the improvements in subjective OSA symptoms in the unsuccessful group may be different from those in the successful group.
Abstract
Objectives. The aims of this study were 1) to evaluate the effect of isolated uvulopalatopharyngoplasty (UPPP) on subjective obstructive sleep apnea (OSA) symptoms in adult patients regardless of the response to surgery, and ultimately 2)to investigate the differences in changes in subjective OSA symptoms between successful and unsuccessful surgery groups. Methods. Twenty consecutive adult patients who underwent isolated UPPP were enrolled. Pre- and postoperative subjective OSA symptoms (snoring, witnessed apnea, daytime sleepiness, morning headache, daytime fatigue, restless sleep,difficulty with morning arousal) and polysomnographic data were evaluated in all subjects. Changes in subjective OSA symptoms before and after surgery were investigated in the successful (n=11) and unsuccessful (n=9) groups. Surgical success was defined as a reduction of at least 50% in the preoperative apnea-hypopnea index (AHI) and a postoperative AHI less than 20 per hour. Results. After isolated UPPP, all subjective OSA symptoms changed significantly in the patients, especially in the successful group. In the unsuccessful group, snoring, witnessed apnea and daytime fatigue changed significantly, while other symptoms did not change significantly after surgery. Conclusion. Isolated UPPP may improve subjective OSA symptoms in adult patients whom surgery was successful or unsuccessful. However, after isolated UPPP, the improvements in subjective OSA symptoms in the unsuccessful group may be different from those in the successful group.
참고문헌 (20)
- American Academy of Sleep Medicine, "The international classification of sleep disorders: diagnostic and coding manual", American Academy of Sleep Medicine, ~ (2005)
- Fogel RB, "Sleep. 2: pathophysiology of obstructive sleep apnoea", hypopnoea syndrome, 2004, pp.59(2), 159~163
- Kakkar RK, "Positive airway pressure treatment for obstructive sleep apnea", Chest, 132(3), pp.1057~1072 (2007)
- Epstein LJ, "Clinical guideline for the evaluation, management and longterm care of obstructive sleep apnea in adults", J Clin Sleep Med, 5(3), pp.263~276 (2009)
- Nelson B. Powell, "Contemporary Surgery for Obstructive Sleep Apnea Syndrome", Clinical and Experimental Otorhinolaryngology, 2(3), pp.107~114 (2009), 대한이비인후과학회
- Caples SM, "Surgical modifications of the upper airway for obstructive sleep apnea in adults: a systematic review and meta-analysis", Sleep, 33(10), pp.1396~1407 (2010)
- Aurora RN, "Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults", Sleep, 33(10), pp.1408~1413 (2010)
- Peker Y, "Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up", Am J Respir Crit Care Med, 166(2), pp.159~165 (2002)
- Walker-Engström ML, "Quality of life assessment of treatment with dental appliance or UPPP in patients with mild to moderate obstructive sleep apnoea: a prospective randomized 1-year follow-up study", J Sleep Res, 9(3), pp.303~308 (2000)
- Haraldsson PO, "Does uvulopalatopharyngoplasty inhibit automobile accidents?", Laryngoscope, 105(6), pp.657~661 (1995)
- Sher AE, "The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome", Sleep, 19(2), pp.156~177 (1996)
- Weaver EM, "Studying life effects & effectiveness of palatopharyngoplasty (SLEEP) study: subjective outcomes of isolated uvulopalatopharyngoplasty", Otolaryngol Head Neck Surg, 144(4), pp.623~631 (2011)
- American Academy of Sleep Medicine, "The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specifications", American Academy of Sleep Medicine, ~ (2007)
- Fujita S, "Surgical correction of anatomic azbnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty", Otolaryngol Head Neck Surg, 89(6), pp.923~934 (1981)
- Powell N, "A reversible uvulopalatal flap for snoring and sleep apnea syndrome", Sleep, 19(7), pp.593~599 (1996)
- Friedman M, "Clinical staging for sleep-disordered breathing", Otolaryngol Head Neck Surg, 127(1), pp.13~21 (2002)
- Li HY, "Critical appraisal and meta-analysis of nasal surgery for obstructive sleep apnea", Am J Rhinol Allergy, 25(1), pp.45~49 (2011)
- Choi JH, "Effectiveness of nasal surgery alone on sleep quality, architecture, position, and sleep-disordered breathing in obstructive sleep apnea syndrome with nasal obstruction", Am J Rhinol Allergy, 25(5), pp.338~341 (2011)
- Weaver EM, "Polysomnography vs self-reported measures in patients with sleep apnea", Arch Otolaryngol Head Neck Surg, 130(4), pp.453~458 (2004)
- Weaver EM, "Polysomnography indexes are discordant with quality of life, symptoms, and reaction times in sleep apnea patients", Otolaryngol Head Neck Surg, 132(2), pp.255~262 (2005)