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Efficacy of endoscopic static pressure/area assessment of the passive pharynx in predicting uvulopalatopharyngoplasty outcomes
Author(s) -
Isono Shiroh,
Shimada Akiko,
Tanaka Atsuko,
Tagaito Yugo,
Utsugi Makoto,
Konno Akiyoshi,
Nishino Takashi
Publication year - 1999
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 - 10.1097/00005537-199905000-00016
Subject(s) - uvulopalatopharyngoplasty , pharynx , medicine , environmental science , surgery , anesthesia , apnea , polysomnography
Objectives/Hypothesis : Although uvulopalatopharyngoplasty (UPPP) is an attractive surgical treatment for obstructive sleep apnea (OSA), the unpredictable outcome limits application of the procedure. Since UPPP corrects only retropalatal airway (RP) patency, we hypothesized that response to UPPP is determined by collapsibility of the retroglossal airway (RG), where UPPP does not correct. Methods : We estimated closing pressure (P close ) for each pharyngeal segment by endoscopically obtaining the static pressure/area relationship of the passive pharynx in completely paralyzed and anesthetized patients with sleep‐disordered breathing (n = 41) before UPPP. Preferable response to UPPP was defined as the number of oxygen dips (ODI), obtained by nocturnal oximetry, less than 10 h −1 after UPPP. Results : Patients with negative P close at RG responded to UPPP significantly better than those with positive P close at RG (22/30 [73%] vs. 3/11 [27%], P < .05). ODI after UPPP was significantly correlated with age, P close at RP, and P close at RG. Conclusions : Endoscopic assessment of anatomic abnormality of the pharynx in paralyzed patients with sleep‐disordered breathing under general anesthesia has clinical value for the improvement of UPPP outcome.