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Efficacy of laser‐assisted uvulopalatoplasty
Author(s) -
Lauretano Arthur M.,
Khosla Rohit K.,
Richardson Gary,
Matheson Jean,
Woodrow Weiss J.,
Graham Camille,
Fried Marvin P.
Publication year - 1997
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/(sici)1096-9101(1997)21:2<109::aid-lsm1>3.0.co;2-u
Subject(s) - medicine , obstructive sleep apnea , respiratory disturbance index , surgery , apnea , polysomnography
Background and Objective Laser‐assisted uvulopalatoplasty (LAUP) is being used increasingly as a surgical treatment for snoring and obstructive sleep apnea (OSA). There is limited evidence for the success of LAUP in eliminating OSA. This study assesses the efficacy of LAUP in eliminating snoring and OSA and addresses which patients may be the best candidates for LAUP treatment. Study Design/Materials and Methods From January 1994 to January 1996, 297 patients were evaluated for snoring, with 190 (64%) exhibiting some degree of OSA documented by a PSG: 41/190 (22%) mild OSA; 33/190 (17%) moderate OSA; 85/190 (45%) severe OSA; 31/190 (16%) severity unknown. Ninety patients (90/297) have undergone LAUP treatment: 58/90 (64%) with OSA and 32/90 (36%) with snoring only. Results Our results indicate a significant reduction of snoring in patients without OSA, but diminishing success in patients with increasing degrees of OSA. Additionally, LAUP was not efficacious in treating OSA: pre‐op respiratory disturbance index (RDI) of 10.8 vs. post‐op RDI of 19.5 for mild OSA ( P = 0.14); pre‐op RDI of 22.9 vs. post‐op RDI of 25.4 for moderate OSA ( P = 0.43); pre‐op RDI of 56.8 vs. post‐op RDI of 46.3 ( P < 0.05), which is statistically but not clinically significant (i.e., RDI remained in the severe range). Conclusion We conclude that LAUP is an effective treatment for nonapneic snoring, but does not provide sufficient resolution of OSA, and based on our results, LAUP should be considered as an adjunctive therapy rather than a sole treatment for OSA in most cases. Lasers Surg. Med. 21:109–116, 1997. © 1997 Wiley‐Liss, Inc.