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Changes in Pharyngeal Properties After Uvulopalatopharyngoplasty
Author(s) -
Wright Stanley,
Zamel Noe,
Haight James,
Hoffstein Victor
Publication year - 1989
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 - 10.1288/00005537-198901000-00012
Subject(s) - uvulopalatopharyngoplasty , medicine , functional residual capacity , pharynx , residual volume , obstructive sleep apnea , lung volumes , anesthesia , sleep apnea , apnea , residual , surgery , polysomnography , lung , mathematics , algorithm
Uvulopalatopharyngoplasty is a commonly used modality for surgical treatment of snoring and obstructive sleep apnea. Although this procedure is thought to alter pharyngeal properties, its effect on pharyngeal mechanics has not been studied. The acoustic reflection technique was used to measure pharyngeal area at functional residual capacity and residual volume before and after uvulopalatopharyngoplasty in eight patients referred because of loud snoring. We also calculated the lung volume dependence of pharyngeal area, defined as the percent change in pharyngeal area between functional residual capacity and residual volume, normalized to the area at functional residual capacity. This parameter, which may be related to pharyngeal collapsibility, was obtained before and after uvulopalatopharyngoplasty. Preoperative sleep studies showed that one patient had obstructive sleep apnea (apnea index > 10). Uvulopalatopharyngoplasty resulted in a significant increase ( p <0.01) in pharyngeal area (from 3.14 ± 0.71 cm 1 to 4.25 ± 1.07 cm 2 ) and residual volume (from 2.49±0.53 cm 2 to 3.91±0.83 cm 2 ). Following uvulopalatopharyngoplasty, the pharynx became stiffer, as manifested by a reduction in lung volume dependence of pharyngeal area from 19±12% to 8±13% ( p <0.05). Six patients, including the patient with obstructive sleep apnea, reported improvement in snoring. Two patients reported worsening in snoring. One of the two was found to have reduction in pharyngeal area and lung volume dependence of pharyngeal area, and an increase in apnea index from 3 to 33. In selected snorers, uvulopalatopharyngoplasty results in improvement in snoring with a concomitant increase in pharyngeal area and a tendency toward lower pharyngeal collapsibility.