Ablation‐Assisted Uvulapalatopharyngoplasty Technique for OSAS Treatment: A 5‐Year Follow‐up Study

Abstract

Objectives: Determine the long-term outcome of patients suffering from obstructive sleep apnea syndrome (OSAS) treated by ablation-assisted uvulapalatopharyngoplasty. Methods: Seventy-five subjects were included between 2005 and 2007. All patients suffered from moderate or severe OSAS. They were treated by radiofrequency volumetric tissue reduction (RFVTR) of the palatopharyngeal abnormal tissues (including tonsillar RFVTR or tonsillectomy), the advance of palatopharyngeal arch after the dissection of palatopharyngeal vault, and the inferior one-third of the palatine velum interspace. Polysomno-graphy (PSG), snoring (assessed on a 10cm visual analog scale [VAS]), marital status, and presence of cardiovascular risk factors or pathologies were evaluated by postal questionnaire. Results: Mean follow-up time was 5.3 ± 1.3 years. Mean snoring intensity decreased significantly in the immediate postoperative period (8.1 ± 2.9 to 3.5 ± 2.2 cm on VAS). Over the longer term, however, we observed a slight increase in snoring intensity (3.7 ± 2.9 cm) ( P > .05). PSG monitoring, RDN (344 ± 38), apnea-hypopnea index (AHI; 59 ± 10), obstructive sleep apnea time (OSAT) (35 ± 13)s, longest obstructive apnea time (LOSAT) (87 ± 26)s, and the mean arterial pressure (145 ± 14) mm Hg in OSAS decreased significantly in the immediate postoperative period ( P < .01). Over the longer term, however, we observed a slight increase in PSG monitoring result ( P > .05) but still better than before surgery ( P < .01). Hypertension and diabetes were diagnosed during follow-up in 12.1% and 6.6% of the subjects, respectively. A minority of patients failed to undergo repeat polysomnography. Conclusions: Ablation-assisted uvulapalatopharyngoplasty is highly effective in the treatment of OSAS. Expected scar formation, enlarged nasopharyngeal and oropharyngeal cavity, reduction of the uvula and lateral pharyngeal bands may contribute to these good success rates.