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Does the length of uvula affect the palatal implant outcome in the management of habitual snoring?
Author(s) -
Akpinar Meltem Esen,
Yigit Ozgur,
Kocak Ismail,
Altundag Aytug
Publication year - 2011
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.21731
Subject(s) - medicine , visual analogue scale , obstructive sleep apnea , odds ratio , implant , polysomnography , logistic regression , tonsil , epworth sleepiness scale , dentistry , body mass index , orthodontics , apnea , surgery
Objectives/Hypothesis: To evaluate the impact of the uvular length on the efficacy of palatal implants in primary snoring. Study Design: Prospective case series, tertiary hospital, snoring and respiratory sleep disorders center. Methods: Forty subjects with inserted palatal implants and diagnoses of primary snoring were included. All met the inclusion criteria of age >18 years, body mass index <30, apnea‐hypopnea index <5, tonsil grade <3, soft‐palate length >25 mm, and Friedman tongue position <3 following clinical, endoscopic, and polysomnographic evaluation. Epworth sleepiness scale (ESS) and the snoring‐intensity visual analogue scale (VAS) were recorded before and 9 months after the implant. Four subjects with extruded implants were excluded; the remaining 36 subjects were divided into two groups, Group I and Group II, with uvular lengths of ≤15 mm and >15 mm, respectively. The study assessed and compared subjective outcome measures including the partner's satisfaction (PS), partner's reported improvement (PRI), 50% VAS and ESS reduction, and subjective success (SS) defined as 50% VAS reduction. The Student t test, χ 2 test, and logistic regression models were used for statistical evaluation. Results: SS (50% VAS reduction), PS, PRI, and 50% ESS reduction were significantly higher in Group I ( P < .001, P = .0257, P = .027, P < .001). The overall SS, PRI, PS, and 50% ESS reduction were 33%, 78%, 50%, and 50%, respectively. The uvular length was found to be the determinant factor of SS ( P = .005; odds ratio = 0.75), PRI ( P = .039; odds ratio = 0.83), and 50% ESS reduction ( P = .038; odds ratio: 0.84) following implant insertion through stepwise logistic regression analysis. Conclusions: Excess uvular length (>15 mm) is an important anatomic feature decreasing the efficacy of palatal implants in snoring, and additional measures, such as uvulectomy, should be considered simultaneously for better outcomes (level 4).