Effect of Modified Uvulopalatopharyngoplasty without Tonsillectomy on Obstructive Sleep Apnea: Polysomnographic Outcome and Correlation with Drug-Induced Sleep Endoscopy

Feng-Hsiang Chiu,1,2 Chih-Yu Chen,1,2 Jih-Chin Lee,1,2 Ying-Shuo Hsu3,4 1Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan; 2National Defense Medical Center, Taipei City, Taiwan; 3Department of Otolaryngology, Shin Kong Wu Ho-Su Memorial Hospital, Taip...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Chiu FH, Chen CY, Lee JC, Hsu YS
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	tonsillectomy uvulopalatopharyngoplasty suspension palatoplasty lateral pharyngoplasty obstructive sleep apnea drug-induced sleep endoscopy complete concentric collapse Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/7ef0ec0a9c834edaaf281783a8d092ff
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:7ef0ec0a9c834edaaf281783a8d092ff
record_format	dspace
spelling	oai:doaj.org-article:7ef0ec0a9c834edaaf281783a8d092ff2021-12-02T15:14:01ZEffect of Modified Uvulopalatopharyngoplasty without Tonsillectomy on Obstructive Sleep Apnea: Polysomnographic Outcome and Correlation with Drug-Induced Sleep Endoscopy1179-1608https://doaj.org/article/7ef0ec0a9c834edaaf281783a8d092ff2021-01-01T00:00:00Zhttps://www.dovepress.com/effect-of-modified-uvulopalatopharyngoplasty-without-tonsillectomy-on--peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Feng-Hsiang Chiu,1,2 Chih-Yu Chen,1,2 Jih-Chin Lee,1,2 Ying-Shuo Hsu3,4 1Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan; 2National Defense Medical Center, Taipei City, Taiwan; 3Department of Otolaryngology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; 4School of Medicine, Fu Jen Catholic University, New Taipei City, TaiwanCorrespondence: Jih-Chin LeeDepartment of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei City, TaiwanTel +886-2-87927192Fax +886-2-87927193Email doc30450@mail.ndmctsgh.edu.twYing-Shuo HsuDepartment of Otolaryngology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei City, TaiwanTel +886-2-28332211 ext.2551Email sulisky@gmail.comObjective: Uvulopalatopharyngoplasty (UPPP) is a common procedure for the treatment of obstructive sleep apnea (OSA) and is usually initiated with the resection of palatine tonsils. Because tonsillectomy potentially contributes to complications, minimally invasive upper airway surgeries have been proposed for OSA therapy. Whether tonsillectomy is always essential for UPPP remains unclear, particularly for patients with small tonsils. The purpose of this study was to present the effect of modified UPPP without tonsillectomy (UPsT) on patients with OSA and attempt to select the candidates for this procedure.Methods: This is a retrospective cohort study of patients with OSA, with tonsil size of grade 0– 2, and with only retropalatal obstruction in drug-induced sleep endoscopy (DISE). The patients underwent UPsT at a tertiary center from November 2017 to December 2019. The sleep study was performed before and at least 3 months after surgery. The demographics, surgical outcomes, and staging patterns of preoperative DISE were recorded. The correlation between surgical outcome and DISE was also established.Results: A total of 22 adults with an average age of 46.5 years [interquartile range: 40 to 60 years] completed the follow-up study. Their apnea–hypopnea index (AHI) and Epworth sleepiness scale values improved significantly after surgery. Of the 17 patients with partial collapse and complete anteroposterior collapse (APC) at the velum, 16 presented good responses to UPsT. However, among the five patients with complete concentric collapse (CCC), only two (2/5, 40%) satisfied the criteria for surgical success. Furthermore, their follow-up AHI values were significantly higher than those of patients without CCC in DISE.Conclusion: UPsT was demonstrated to be an effective therapy for patients with OSA who had small tonsils and retropalatal obstruction in DISE. CCC in sleep endoscopy indicates a poorer surgical outcome than does complete APC and partial collapse at the velum.Keywords: tonsillectomy, uvulopalatopharyngoplasty, suspension palatoplasty, lateral pharyngoplasty, obstructive sleep apnea, drug-induced sleep endoscopy, complete concentric collapseChiu FHChen CYLee JCHsu YSDove Medical Pressarticletonsillectomyuvulopalatopharyngoplastysuspension palatoplastylateral pharyngoplastyobstructive sleep apneadrug-induced sleep endoscopycomplete concentric collapsePsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 13, Pp 11-19 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	tonsillectomy uvulopalatopharyngoplasty suspension palatoplasty lateral pharyngoplasty obstructive sleep apnea drug-induced sleep endoscopy complete concentric collapse Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	tonsillectomy uvulopalatopharyngoplasty suspension palatoplasty lateral pharyngoplasty obstructive sleep apnea drug-induced sleep endoscopy complete concentric collapse Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Chiu FH Chen CY Lee JC Hsu YS Effect of Modified Uvulopalatopharyngoplasty without Tonsillectomy on Obstructive Sleep Apnea: Polysomnographic Outcome and Correlation with Drug-Induced Sleep Endoscopy
description	Feng-Hsiang Chiu,1,2 Chih-Yu Chen,1,2 Jih-Chin Lee,1,2 Ying-Shuo Hsu3,4 1Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan; 2National Defense Medical Center, Taipei City, Taiwan; 3Department of Otolaryngology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; 4School of Medicine, Fu Jen Catholic University, New Taipei City, TaiwanCorrespondence: Jih-Chin LeeDepartment of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei City, TaiwanTel +886-2-87927192Fax +886-2-87927193Email doc30450@mail.ndmctsgh.edu.twYing-Shuo HsuDepartment of Otolaryngology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei City, TaiwanTel +886-2-28332211 ext.2551Email sulisky@gmail.comObjective: Uvulopalatopharyngoplasty (UPPP) is a common procedure for the treatment of obstructive sleep apnea (OSA) and is usually initiated with the resection of palatine tonsils. Because tonsillectomy potentially contributes to complications, minimally invasive upper airway surgeries have been proposed for OSA therapy. Whether tonsillectomy is always essential for UPPP remains unclear, particularly for patients with small tonsils. The purpose of this study was to present the effect of modified UPPP without tonsillectomy (UPsT) on patients with OSA and attempt to select the candidates for this procedure.Methods: This is a retrospective cohort study of patients with OSA, with tonsil size of grade 0– 2, and with only retropalatal obstruction in drug-induced sleep endoscopy (DISE). The patients underwent UPsT at a tertiary center from November 2017 to December 2019. The sleep study was performed before and at least 3 months after surgery. The demographics, surgical outcomes, and staging patterns of preoperative DISE were recorded. The correlation between surgical outcome and DISE was also established.Results: A total of 22 adults with an average age of 46.5 years [interquartile range: 40 to 60 years] completed the follow-up study. Their apnea–hypopnea index (AHI) and Epworth sleepiness scale values improved significantly after surgery. Of the 17 patients with partial collapse and complete anteroposterior collapse (APC) at the velum, 16 presented good responses to UPsT. However, among the five patients with complete concentric collapse (CCC), only two (2/5, 40%) satisfied the criteria for surgical success. Furthermore, their follow-up AHI values were significantly higher than those of patients without CCC in DISE.Conclusion: UPsT was demonstrated to be an effective therapy for patients with OSA who had small tonsils and retropalatal obstruction in DISE. CCC in sleep endoscopy indicates a poorer surgical outcome than does complete APC and partial collapse at the velum.Keywords: tonsillectomy, uvulopalatopharyngoplasty, suspension palatoplasty, lateral pharyngoplasty, obstructive sleep apnea, drug-induced sleep endoscopy, complete concentric collapse
format	article
author	Chiu FH Chen CY Lee JC Hsu YS
author_facet	Chiu FH Chen CY Lee JC Hsu YS
author_sort	Chiu FH
title	Effect of Modified Uvulopalatopharyngoplasty without Tonsillectomy on Obstructive Sleep Apnea: Polysomnographic Outcome and Correlation with Drug-Induced Sleep Endoscopy
title_short	Effect of Modified Uvulopalatopharyngoplasty without Tonsillectomy on Obstructive Sleep Apnea: Polysomnographic Outcome and Correlation with Drug-Induced Sleep Endoscopy
title_full	Effect of Modified Uvulopalatopharyngoplasty without Tonsillectomy on Obstructive Sleep Apnea: Polysomnographic Outcome and Correlation with Drug-Induced Sleep Endoscopy
title_fullStr	Effect of Modified Uvulopalatopharyngoplasty without Tonsillectomy on Obstructive Sleep Apnea: Polysomnographic Outcome and Correlation with Drug-Induced Sleep Endoscopy
title_full_unstemmed	Effect of Modified Uvulopalatopharyngoplasty without Tonsillectomy on Obstructive Sleep Apnea: Polysomnographic Outcome and Correlation with Drug-Induced Sleep Endoscopy
title_sort	effect of modified uvulopalatopharyngoplasty without tonsillectomy on obstructive sleep apnea: polysomnographic outcome and correlation with drug-induced sleep endoscopy
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/7ef0ec0a9c834edaaf281783a8d092ff
work_keys_str_mv	AT chiufh effectofmodifieduvulopalatopharyngoplastywithouttonsillectomyonobstructivesleepapneapolysomnographicoutcomeandcorrelationwithdruginducedsleependoscopy AT chency effectofmodifieduvulopalatopharyngoplastywithouttonsillectomyonobstructivesleepapneapolysomnographicoutcomeandcorrelationwithdruginducedsleependoscopy AT leejc effectofmodifieduvulopalatopharyngoplastywithouttonsillectomyonobstructivesleepapneapolysomnographicoutcomeandcorrelationwithdruginducedsleependoscopy AT hsuys effectofmodifieduvulopalatopharyngoplastywithouttonsillectomyonobstructivesleepapneapolysomnographicoutcomeandcorrelationwithdruginducedsleependoscopy
_version_	1718387578455982080

Effect of Modified Uvulopalatopharyngoplasty without Tonsillectomy on Obstructive Sleep Apnea: Polysomnographic Outcome and Correlation with Drug-Induced Sleep Endoscopy

Ejemplares similares