Abstract
Precise identification of the site of obstruction in obstructive sleep apnea (OSA) is essential in the selection of good candidates for surgical treatment. Pressure measurements of the upper airway were performed in 76 OSA patients and 20 patients who underwent UPPP. By applying nasal continuous positive airway pressure (CPAP), artifactual data due to total airway collapse was avoided, and the site of obstruction could be confirmed by changing the CPAP pressure. In the baseline condition, 18 cases showed obstruction around the soft palate and 21 cases showed obstruction around the base of tongue. In the remaining 37 cases, both levels of obstruction were indicated. In the CPAP condition, 37 cases showed obstruction around the soft palate and 30 cases around the base of the tongue. The remaining 9 cases indicated both levels of obstruction. In the UPPP cases, 12 had showed more than a 50% reduction in the AHI (apnea + hypopnea index) after surgery (good responders), and 8 cases showed less than a 50% reduction in the AHI after surgery (poor responders). All of the good responders had showed an obstruction around the soft palate, and 50% of the poor responder had showed an obstruction around the base of the tongue before surgery. It is curious that 5 of the poor responders showed a remaining stenosis at the level of the soft palate after UPPP.
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