Impact of Minimally Invasive Multilevel Surgery on Mild/Moderate OSA. (October 2016)

• Record Type: Journal Article
• Authors: Salapatas, Anna M.; Bonzelaar, Lauren B.; Hwang, Michelle S.; Goyal, Vinay; Bakhsheshian, Joshua; Ellenberg, Elie C.; Friedman, Michael
• Is Part Of: Otolaryngology--head and neck surgery. Volume 155:Number 4(2016:Oct.)
• Page Start: 695
• Page End: 701
• Publication Date: 2016-10
• Subjects: sleep apnea -- OSA -- pillar implant -- radiofrequency -- minimally invasive -- multilevel -- treatment -- UPPP -- uvulopalatopharyngoplasty -- snoring -- daytime sleepiness -- ESS -- AHI; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599816651240
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: To assess 10-year data on subjective and objective improvements in patients with mild to moderate obstructive sleep apnea (OSA) after single-stage multilevel minimally invasive surgery. Study Design: Case series with chart review. Setting: Tertiary academic center. Subjects and Methods: A chart review was conducted of 601 patients diagnosed with mild to moderate OSA who were treated with single-stage multilevel minimally invasive surgery from January 2005 to January 2015. Patients were treated with a combination of procedures that included various nasal procedures, palatal stiffening, and radiofrequency tongue base reduction. Demographics and objective and subjective parameters were collected; all patients were included who had a mean of 6 months of follow-up data available. Pre- and postoperative values were compared. Results: A total of 601 patients were included in this study (67.0% male; age, 38.2 ± 9.4 years; mean body mass index, 27.4 ± 4.1 kg/m 2 ). Mean apnea-hypopnea index decreased significantly from 19.8 ± 5.9 events per hour preoperatively to 12.7 ± 7.6 events per hour postoperatively ( P < .0001), with a 45.9% rate of "surgical success." Mean daytime sleepiness decreased significantly from 12.1 ± 4.8 to 6.8 ± 2.9 ( P < .001) per the Epworth Sleepiness Scale. Mean snoring intensity showed a significant decrease from 8.8 ± 0.8 to 4.0 ± 2.1 ( P < .001). Conclusion: Ten-year experience shows that treatment with single-stage multilevel minimally invasive surgery decreases objective and subjective measures in selected patients with mild to moderate OSA. Although not curative, this technique helps to control symptoms in a population of patients who refused CPAP.