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Minimally Invasive Single‐Stage Multilevel Treatment for Obstructive Sleep Apnea/Hypopnea Syndrome
Author(s) -
Friedman Michael,
Lin HsinChing,
Gurpinar Berk,
Joseph Ninos J.
Publication year - 2007
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/mlg.0b013e3180f62b4d
Subject(s) - obstructive sleep apnea , hypopnea , medicine , stage (stratigraphy) , sleep (system call) , apnea–hypopnea index , sleep apnea , apnea , polysomnography , cardiology , computer science , biology , paleontology , operating system
Objectives: To assess subjective and objective improvement after single‐stage multilevel minimally invasive treatment for obstructive sleep apnea/hypopnea syndrome (OSAHS). Study Design: A retrospective review of a prospective dataset of patients treated in a tertiary care referral center. Methods: Charts of 145 patients with mild/moderate OSAHS treated with a single‐stage multilevel minimally invasive technique were reviewed to abstract pre‐ and posttreatment symptoms and polysomnographic data. One hundred twenty‐two patients had minimum follow‐up of 6 (range, 6–23) months and complete data available for analysis. All patients studied had three‐level treatment that included nasal surgery, palatal stiffening by Pillar implant technique, and radiofrequency volume reduction of the tongue base. Primary outcomes included change from baseline in apnea/hypopnea index (AHI). Secondary outcomes included change in Epworth Sleepiness Scale (ESS) and bed‐partner assessed snoring visual analogue scale (VAS, 0–10), pain levels, narcotic use, and complications. Results: Mean AHI decreased from 23.2 ± 7.6 preoperatively to 14.5 ± 10.2 postoperatively ( P < .0001). Classical “cure” was achieved in 54 (47.5%) patients. Mean ESS decreased from 9.7 ± 3.9 preoperatively to 6.9 ± 3.3 postoperatively ( P < .0001). Mean snoring VAS decreased from 9.4 ± 0.9 preoperatively to 3.2 ± 2.4 postoperatively ( P <. 0001). Conclusion: Polysomnographic respiratory parameters, ESS, and snoring VAS significantly improved in patients with mild/moderate OSAHS treated with single‐stage multilevel minimally invasive surgery. Multilevel minimally invasive single‐stage surgery is a valid option for selected patients with mild/moderate OSAHS with the understanding that they may require secondary treatment.