Therapeutic effectiveness of the soft palate fold surgery in patients with obstructive sleep apnea hypopnea syndrome

Abstract

Objective: To evaluate the relationships between anatomical changes and treatment outcomes after modified velopharyngeal surgery in obstructive sleep apnea hypopnea syndrome (OSAHS) patients with the soft palate drooping. Methods: From November 2011 to November 2015, 44 OSHS patients (AHI 5-30 times/h) with the soft palate drooping determined by Muller test and drug-induced sleep endoscopy (DISE) were randomly selected. Treatment group included 23 patients who underwent modified velopharyngeal surgery, in which uvula was preserved and soft palate was shortened and advanced. Control group included 21 patients who received conventional UPPP surgery.Compared the differences in preoperative and postoperative Epworth Sleepiness Scale (ESS), Numeric Rating Scale (NRS), lowest arterial blood oxygen saturation (LSaO(2)), and apnea hypoventilation index (AHI) between the two groups. Each data rows normality test. The two groups' preoperative and postoperative data row intra-group comparison and matching t test. Used the independent sample t test after homogeneity of variance test to compare the two groups. The difference was statistically significant when P<0.05. Results: There were statistically significant differences in AHI , LSaO(2) and ESS score between before and after surgery in individual groups. There were not significant differences in preoperative AHI and LSaO(2) between the two groups, but with a higher ESS in treatment group compared to control group. There were no statistically significant differences in postoperative AHI, LSaO(2) or ESS between the two groups. Compared with control group, treatment group had a lower postoperative pain scale score (4.3±1.3 vs 6.3±0.8, P=0.000) and a shorter time to resume normal eating ((6.7±1.6) d vs (15.5±3.5) d, P=0.000). Conclusion: OSAHS patients (AHI 5-30 times/h) with the soft palate drooping are more likely to have favorable anatomical changes after revised velopharyngeal surgery.