Open AccessVelopharyngeal Surgery for Patients with Small Tonsils
Author(s) -
Ye Jingying,
Zhang Junbo,
Xian Junfang,
Wang Jiangyong,
Dong Jiajia
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451438a278
Subject(s) - uvulopalatopharyngoplasty , medicine , obstructive sleep apnea , polysomnography , tonsillectomy , airway , tonsil , concomitant , apnea , surgery , anesthesia
Objective To explore the relationship between anatomical changes and treatment response in obstructive sleep apnea (OSA) patients with small tonsils (tonsil grades 0‐2 according to Friedman staging system) after velopharyngeal surgery. Method Thirty‐six patients with small tonsils underwent velopharyngeal surgery that consisted of revised uvulopalatopharyngoplasty with uvula preservation (H‐UPPP) and concomitant transpalatal advancement pharyngoplasty, 3‐dimensional CT of upper airway, and polysomnography performed before and after surgery were obtained for comparison and analysis. Results Overall apnea‐hypopnea index (AHI) decreased from 56.8 (37.5, 70.1) to 16.1 (10.8, 33.5) ( P <. 001) after surgery. The changes of several anatomical parameters differed significantly between responders and non‐responders ( P <. 05), and the change of minimal cross‐sectional area of velopharynx (VmCSA) was independently predictive of the change of AHI ( P <. 001, r 2 = 0.271). The correlation analysis showed that the change of VmCSA significantly correlated with preoperative VmCSA ( r = −0.383, P =. 021). Conclusion In patients with small tonsils an increase in VmCSA is related to a good surgical response, and such patients who have a relatively smaller preoperative VmCSA are more likely to get favorable anatomical changes.