The safety and short-term efficacy of modified lateral pharyngoplasty combined with multilevel surgery for OSA

Abstract

Objective:To explore the safety and short-term efficiency of modified lateral pharyngoplasty combined with surgeries in other sites including nose and tongue. Methods:Thirty-five patients with OSA confirmed with polysomnography received modified lateral pharyngoplasty under general anesthesia. Some of the patients may also receive glossopharyngeal or nasal surgeries according to their physical examination, Müller test with electronic nasolaryngology and polysmnography. The postoperativepain, capacities of swallowing and speaking, and related postoperative complications after surgeries were recorded. And the changes of epworth sleep scale （ESS） snoring sore, apnea and hypopnea index （AHI） and lowest oxygen saturation （LSaO2） were compared before and after surgeries. Results:Among the 35 patients, 1 patient experienced experienced dyspnea after extubation and 2 patients experienced postoperative bleeding. The mean VAS after 1, 4 and 7 days of the surgery were 5.41±2.42, 2.93±1.80, 2.91±1.26, respectively. The mean pain visual analogue scale（VAS） was 5.41±2.42, 2.93±1.80 and 2.91±1.26 on the 1st, 4th and 7th day after operation. The mean time of starting to eat liquid and semi-liquid were （3.23±2.11） dand （5.55±2.67） d after surgery, respectively. Twenty-eight patients underwent 3-6 months follow-up, there was no significant difference in body mass index （BMI） before and after surgery, while mean ESS and snore index were significantly improved, ESS decreased from 11.33±4.91 to 6.19±4.45, and snore index decreased from 6.93±2.23 to 1.25±1.96. Among them, 23 of patients those patients received polysomnography after surgeries, AHI, LSaO2 and time with oxygen saturation below 90% （CT90） were significantly improvement. The mean AHI decreased from 45.05±27.90/h to 18.61±20.85/h，and mean SaO2 increased from 71.17% to 80.87%. Conclusion:Modified lateral pharyngoplasty combined with selective nasal and lingual plane surgery in the treatment of OSA is safe and can significantly improve ESS, snoring, AHI， LSaO2and other indicators.Modified lateral pharyngoplasty selectively with surgeries of nose or tongue is a kind of safe and effective surgery to treat OSA that ESS, snoring, AHI and SaO2can have satisfactory improvement.