Unpredictable results of laser assisted uvulopalatoplasty in the treatment of obstructive sleep apnoea. Issue 5 (1st May 2000)

• Record Type: Journal Article
• Authors: Ryan, C F; Love, L L
• Is Part Of: Thorax. Volume 55:Issue 5(2000)
• Page Start: 399
• Page End: 404
• Publication Date: 2000-05-01
• Subjects: obstructive sleep apnoea -- uvulopalatoplasty -- laser assisted uvulopalatoplasty; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax.55.5.399
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : BACKGROUND: Laser assisted uvulopalatoplasty (LAUP) is increasingly offered for the treatment of obstructive sleep apnoea (OSA), although there is a lack of objective data to support its indications and efficacy. A study was undertaken to determine the treatment response to LAUP. METHODS: Overnight polysomnography was performed before and at least three months after surgery in 44 consecutive patients with symptomatic mild to moderate OSA (apnoea + hypopnoea index (AHI) >10/h). Pharyngeal dimensions were measured by videoendoscopy (n = 11) and disease-specific quality of life, sleepiness and snoring frequency (n = 16) before and after surgery were determined in subgroups of patients. LAUP was performed under local anaesthesia as a one stage resection of the uvula and soft palate by one of two experienced otolaryngologists. RESULTS: Twelve patients (27%) had a good response (AHI ⩽10/h after LAUP); four (9%) had a partial response (AHI ⩽50% of pre-LAUP value); 15 (34%) had a poor response (AHI >50% of pre-LAUP value); and 13 (30%) patients were worse (AHI >100% of pre-LAUP value). The velopharyngeal cross sectional area and anteroposterior diameter increased following LAUP (p<0.05). Quality of life indices improved significantly in all domains and sleepiness decreased. The snoring index did not decrease significantly. No preoperative anthropometric or videoendoscopic measures were predictive of a good response to LAUP. Patients who were worse after LAUP had milder baseline apnoea severity than those in the other response groups. CONCLUSIONS: The treatment response to LAUP is variable and unpredictable, and only a few patients achieve a satisfactory response. There appears to be no relationship between subjective and objective measures of treatment efficacy.