One-Stage Multilevel Surgery for Treatment of Obstructive Sleep Apnea Syndrome

We report the results of one-stage multilevel upper airway surgery for patients who could not tolerate continuous positive airway pressure (CPAP). Patients treated with multilevel surgery at a University Hospital in 2015–2019 were identified from a prospectively maintained database. The inclusion cr...

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Autores principales:	Gabriela Bosco, Marta Morato, Nuria Pérez-Martín, Andrés Navarro, Miguel A. Racionero, Carlos O’Connor-Reina, Peter Baptista, Guillermo Plaza
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	obstructive sleep apnea multilevel surgery tongue base surgery sleep surgery Medicine R
Acceso en línea:	https://doaj.org/article/bdc9c75d493443a7ac12024ca324f2c1
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spelling	oai:doaj.org-article:bdc9c75d493443a7ac12024ca324f2c12021-11-11T17:29:38ZOne-Stage Multilevel Surgery for Treatment of Obstructive Sleep Apnea Syndrome10.3390/jcm102148222077-0383https://doaj.org/article/bdc9c75d493443a7ac12024ca324f2c12021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4822https://doaj.org/toc/2077-0383We report the results of one-stage multilevel upper airway surgery for patients who could not tolerate continuous positive airway pressure (CPAP). Patients treated with multilevel surgery at a University Hospital in 2015–2019 were identified from a prospectively maintained database. The inclusion criteria were aged 18–70 years, body mass index (BMI) < 35 kg/m<sup>2</sup>, apnea–hypopnea index (AHI) > 20, and lingual tonsil hypertrophy grade 3 or 4. Drug-induced sleep endoscopy was performed before surgery in all patients. Multilevel surgery was performed in one stage and included expansion sphincter pharyngoplasty (ESP), coblation tongue base reduction (CTBR), and partial epiglottectomy (PE) as required. The outcome measures were postoperative AHI, time percentage oxygen saturation < 90%, and Epworth Sleepiness Scale (ESS) score. A total of 24 patients were included: median age 49.1 years, average BMI 27.26 kg/m<sup>2</sup>, and 90% men. Ten patients received ESP plus CTBR plus PE, eight received ESP plus CTBR, and six received ESP plus PE. The mean preoperative AHI was 33.01 at baseline and improved to 17.7 ± 13 after surgery (<i>p</i> < 0.05). The ESS score decreased from 11 ± 5.11 to 7.9 ± 4.94 (<i>p</i> < 0.05). The surgical success rate according to Sher’s criteria was 82.3%. The median follow-up was 23.3 months (range 12–36). These findings suggest that multilevel surgery is a safe and successful treatment of OSAHS.Gabriela BoscoMarta MoratoNuria Pérez-MartínAndrés NavarroMiguel A. RacioneroCarlos O’Connor-ReinaPeter BaptistaGuillermo PlazaMDPI AGarticleobstructive sleep apneamultilevel surgerytongue base surgerysleep surgeryMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4822, p 4822 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	obstructive sleep apnea multilevel surgery tongue base surgery sleep surgery Medicine R
spellingShingle	obstructive sleep apnea multilevel surgery tongue base surgery sleep surgery Medicine R Gabriela Bosco Marta Morato Nuria Pérez-Martín Andrés Navarro Miguel A. Racionero Carlos O’Connor-Reina Peter Baptista Guillermo Plaza One-Stage Multilevel Surgery for Treatment of Obstructive Sleep Apnea Syndrome
description	We report the results of one-stage multilevel upper airway surgery for patients who could not tolerate continuous positive airway pressure (CPAP). Patients treated with multilevel surgery at a University Hospital in 2015–2019 were identified from a prospectively maintained database. The inclusion criteria were aged 18–70 years, body mass index (BMI) < 35 kg/m<sup>2</sup>, apnea–hypopnea index (AHI) > 20, and lingual tonsil hypertrophy grade 3 or 4. Drug-induced sleep endoscopy was performed before surgery in all patients. Multilevel surgery was performed in one stage and included expansion sphincter pharyngoplasty (ESP), coblation tongue base reduction (CTBR), and partial epiglottectomy (PE) as required. The outcome measures were postoperative AHI, time percentage oxygen saturation < 90%, and Epworth Sleepiness Scale (ESS) score. A total of 24 patients were included: median age 49.1 years, average BMI 27.26 kg/m<sup>2</sup>, and 90% men. Ten patients received ESP plus CTBR plus PE, eight received ESP plus CTBR, and six received ESP plus PE. The mean preoperative AHI was 33.01 at baseline and improved to 17.7 ± 13 after surgery (<i>p</i> < 0.05). The ESS score decreased from 11 ± 5.11 to 7.9 ± 4.94 (<i>p</i> < 0.05). The surgical success rate according to Sher’s criteria was 82.3%. The median follow-up was 23.3 months (range 12–36). These findings suggest that multilevel surgery is a safe and successful treatment of OSAHS.
format	article
author	Gabriela Bosco Marta Morato Nuria Pérez-Martín Andrés Navarro Miguel A. Racionero Carlos O’Connor-Reina Peter Baptista Guillermo Plaza
author_facet	Gabriela Bosco Marta Morato Nuria Pérez-Martín Andrés Navarro Miguel A. Racionero Carlos O’Connor-Reina Peter Baptista Guillermo Plaza
author_sort	Gabriela Bosco
title	One-Stage Multilevel Surgery for Treatment of Obstructive Sleep Apnea Syndrome
title_short	One-Stage Multilevel Surgery for Treatment of Obstructive Sleep Apnea Syndrome
title_full	One-Stage Multilevel Surgery for Treatment of Obstructive Sleep Apnea Syndrome
title_fullStr	One-Stage Multilevel Surgery for Treatment of Obstructive Sleep Apnea Syndrome
title_full_unstemmed	One-Stage Multilevel Surgery for Treatment of Obstructive Sleep Apnea Syndrome
title_sort	one-stage multilevel surgery for treatment of obstructive sleep apnea syndrome
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/bdc9c75d493443a7ac12024ca324f2c1
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One-Stage Multilevel Surgery for Treatment of Obstructive Sleep Apnea Syndrome

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