Abstract
Background and Objectives:
Surgical treatment is considered as a secondary treatment option for obstructive sleep apnea (OSA). This study was performed to determine whether surgical treatment can be considered in patients with moderate-severe OSA as a treatment modality. Materials and Method: A total of 127 patients with moderate-severe OSA were retrospectively enrolled. The anatomic narrowing sites were mainly evaluated using cephalometry and drug induced sleep endoscopy (DISE), and then multilevel surgeries were performed.
Results:
Both uvula and soft palate were the most frequent narrowing sites and a total of 110 patients showed upper airway narrowing more than two anatomic structures. A total of 79 patients (62.1%) were categorized as responders and 48 patients (39.1%) were non-responders. After multilevel sleep surgeries, patients’ subjective symptoms and sleep parameters were sig-nificantly improved. However, AHI was not considerably decreased. Non-responders to sleep surgeries showed relatively higher rates of severe OSA and body mass index. Tongue base narrowing, incomplete corrections of nasal pathologies and soft palate were significant factors for lower success rates.
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Fig. 1.
The obstruction site and its frequency through the DISE examination ( A), Total number of narrowing sites in each pa-tient ( B).
![jr-24-20f1.tif](/upload/SynapseXML/0131jr/thumb/jr-24-20f1.gif)
Fig. 4.
The findings of anatomic structures in non-responders ( N=48) at 3 months after sleep surgeries.
![jr-24-20f4.tif](/upload/SynapseXML/0131jr/thumb/jr-24-20f4.gif)
Table 1.
Changes in the sleep-related parameters after sleep surgery
Preoperative | Postoperative | p-value | |
---|---|---|---|
ESS score | 11.7±4.3 | 6.7±2.6 | ∗ |
VAS for snoring | 6.6±1.2 | 2.7±0.5 | ∗ |
VAS for apnea | 8.1±2.8 | 4.2±0.6 | ∗ |
AHI | 25.8±9.2 | 20.1±9.2 | |
ODI | 20.1±6.9 | 14.4±6.5 | ∗ |
Mean O2 saturation (%) | 88.1±5.2 | 94.5±4.3 | ∗ |
Valid sleep time (time) | 381.4±41.2 | 412±38.9 | ∗ |
Snoring intensity (dB) | 50.4±19.2 | 32.6±11.5 | ∗ |
Table 2.
The comparision of preoperative sleep parameters between responders and non-responder group
Responder ( N=74) N | Non-responder ( N=53) | p-value | |
---|---|---|---|
BMI | 24.7±3.8 | 29.8±4.6 | ∗ |
ESS score | 14.2±7.3 | 13.8±4.2 | |
AHI | 27.9±6.5 | 29.3±5.1 | |
ODI | 23.5±3.9 | 24.9±4.7 | |
Mean O2 saturation (%) | 87.3±4.2 | 88.6±7.6 |