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Concurrent palatal implants and uvulopalatal flap: Safe and effective office‐based procedure for selected patients with snoring and obstructive sleep apnea syndrome
Author(s) -
Huang TsungWei,
Cheng PoWen,
Fang KaiMin
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.22129
Subject(s) - medicine , obstructive sleep apnea , visual analogue scale , polysomnography , anesthesia , apnea , soft palate , surgery , sleep apnea
Objectives/Hypothesis: An outpatient surgical procedure for snoring and obstructive sleep apnea syndrome (OSAS) should not only stiffen the soft palate, but also widen the opening of retropalatal space. This study presents a concurrent palatal implants (PI) and uvulopalatal flap (UPF) in the outpatient setting under local anesthesia for OSAS patients. Study Design: Prospective study. Methods: Patients with snoring and more than or an equivalent of 5 events hourly but less than 20 hourly on the apnea–hypopnea index (AHI) were enrolled. Three office‐based procedures were performed, that is, PI, UPF, and PI concurrent with UPF (PI‐UPF). Postoperative pain was evaluated using a visual analog scale. Before surgery and after surgery, subjective outcomes were assessed using the snoring scale, and objective outcomes were assessed using overnight polysomnography. Results: Sixty‐three patients underwent office‐based procedures for OSAS. Among them, 21 underwent PI, 20 underwent UPF, and 22 underwent PI‐UPF. PI attained the lowest postoperative pain scores. At 6 months after surgery, the mean snoring scale in PI, UPF, and PI‐UPF group were 3.7 ± 0.7, 3.2 ± 0.8, and 1.8 ± 0.6, respectively ( P < .05). The mean AHI scores in group PI, UPF, and PI‐UPF were 9.0 ± 4.6, 8.8 ± 4.0, and 6.1 ± 2.5 events per hour, respectively ( P < .05). The mean snoring index in group PI, UPF, and PI‐UPF were 120.6 ± 79.5, 115.7 ± 86.3, and 71.8 ± 41.7 events per hour, respectively ( P < .05). Conclusions: Concurrent PI and UPF is a safe and effective office‐based procedure for selected patients with OSAS and snoring.