Outcomes of upper airway surgery in obstructive sleep apnea

Abstract

Background and Objective: Obstructive sleep apnea (OSA) is defined as a sleep disordered breathing due to partial or complete obstruction of upper airways. This study aimed to investigate treatment outcomes and clinical complications among patients with OSA who underwent upper airway surgery in clinical settings. Materials and Methods: All patients undergone upper airway surgery for OSA were called upon to enroll in this follow-up study. Demographic characteristics, Epworth sleepiness scale (ESS), snoring, dry mouth, nocturia, improvement of high blood pressure, and complications of surgery including bleeding, infection, pain, and temporary voice change were recorded at median of 8 months after the surgery. 12 patients accepted to undergo follow-up polysomnography (PSG). Results: Among 41 participants, mean age was 44.2 ± 11.6 years, and 33 (78.6%) were male. In three patients (25%) with follow-up PSG, mean respiratory disturbance index (RDI) was decreased by 50%. The baseline and post-surgery RDI was 34.0 ± 26.2 and 24.8 ± 13.2/hours, respectively. Mean ESS pre-surgery was 9.0 ± 4.5 with a decrease of 3.9 ± 4.2 post-surgery. Most of the participants reported improved snoring. More than half of the patients reported improvement of hypertension, dry mouth, nocturia, and sleep quality. The most common reported complications were temporary changes in voice and pain. Conclusion: Surgery improved snoring, daytime sleepiness, and OSA-related problems. RDI improvement in a small subset of patients indicates importance of follow-up PSG after upper airway surgery and warrants further studies. Moreover, evaluation of the reasons of non-participation for undergoing follow-up PSG requires more investigation.