Upper airway changes after H-uvulopalatopharyngoplasty combined with transpalatal advancement pharyngoplasty in patients with obstructive sleep apnea hypopnea syndrome

Abstract

Objective To compare the upper airway changes after H-uvulopalatopharyngoplasty (H-UPPP) combined with transpalatal advancement pharyngoplasty (PA) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Eighty-six patients with OSAHS were selected,39 patients were treated with H-UPPP alone (control group),and 47 patients were treated with H-UPPP combined with PA (observation group).The upper airway changes were measured by CT and apnea hypopnea index (AHI) change in the 2 groups were compared before and after operation.Results The surgery effective rate in observation group was 80.9％ (38/47),in control group was 56.4％ (22/39),there was statistical difference (P ＜ 0.05).The AHI depressed value before and after operation in observation group and control group were (40.5 ± 14.6) times/h and (16.7 ± 12.0) times/h respectively,the hard palate length depressed value were (5.5 ± 3.2) mm and (1.6 ± 0.2) mm respectively,the anteroposterior diameter incremental value of hard palate were (3.6 ± 2.3) mm and (-1.6 ± 3.4) mm respectively,the anteroposterior diameter incremental value of palate and pharynx were (1.6 ± 1.2) mm and (-1.2 ± 1.8) mm respectively,the above indexes in observation group were significantly better than those in control group,there were statistical differences (P ＜ 0.05).The minimum diameter incremental value of retropalatal airway in control group was (13.2 ± 3.1) mm,in observation group was (4.9 ± 1.6) mm,there was statistical difference (P ＜ 0.05).Conclusion H-UPPP combined with PA offers benefit over H-UPPP alone in patients with OSAHS,which may be achieved by increasing anteroposterior diameter of palate and pharynx. Key words: Sleep apnea,obstructive; Upper airway; H-uvulopalatopharyngoplasty; Transpalatal advancement pharyngoplasty