Surgical treatment outcome of obstructive sleep apnea patient with nasal cavity and oropharyngeal airway abnormality

Abstract

Background: The purpose of this study was to evaluate the result of the multilevel single-stage procedure for obstructive sleep apnea (OSA) with a narrow nasal cavity and oropharyngeal, velopharyngeal airspace. A retrospective study was performed in OSA patients who underwent surgery in Khon Kaen hospital, Thailand. Methods: A retrospective study was conducted and medical records were reviewed between 2015 May and 2019 November in patients with loud snoring and having symptoms and signs of OSA, 43 patients included for evaluation history taking and physical examination by fiberoptic laryngoscope and performed multilevel single-stage procedure and evaluated clinical postoperative. Results: All patients were evaluated preoperatively by a history taking and physical examination for clinical assessment including fiberoptic laryngoscope examination. There were 3 surgical procedure, Procedure 1: 12 patients underwent Tonsillectomy with uvulopalatopharyngoplasty (27.9%), Procedure 2: 22 patients underwent Tonsillectomy with uvulopalatopharyngoplasty and inferior turbinoplasty (51.2%), Procedure 3: 9 patients underwent Tonsillectomy with uvulopalatopharyngoplasty and inferior turbinoplasty, and septoplasty (20.9%). After a 1-week post-operation 41 patients (95.3%), all (100.0%) no symptoms of OSA, and 60.9% improved their loud snoring more than 80.0%. After 3-week post-operation, 32 patients (74.4%) followed up and all (100.0%) no symptoms of OSA, 27 patients (84.4%) improved their loud snoring by more than 80.0%. Conclusion: Clinical assessment in patient with OSA is important before treatment. The Multilevel single-stage procedure is alternative choice for first treatment of OSA patients who reject continuous positive airway pressure (CPAP) or failure using CPAP. The results outcome is good for both obesity and non-obesity patients and improve clinical in OSA.