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Long-term Follow-up of Patients With Obstructive Sleep Apnea Treated With Uvulopalatopharyngoplasty
Christer Janson, MD, PhD;
Thorarinn Gislason, MD, PhD;
Harriet Bengtsson, MD;
Gösta Eriksson, MSc;
Eva Lindberg, MD;
Carl-Erik Lindholm, MD, PhD;
Elisabeth Hultcrantz, MD, PhD;
Jerker Hetta, MD, PhD;
Gunnar Boman, MD, PhD
Arch Otolaryngol Head Neck Surg. 1997;123(3):257-262.
Abstract
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Objective
To study the long-term outcome after treatment with uvulopalatopharyngoplasty (UPPP).
Design
Long-term follow-up (4-8 years) with polysomnography.
Setting
Referral center for patients with sleep-disordered breathing.
Patients
Thirty-four consecutive patients of whom 25 (22 men and 3 women; mean age, 49 years) participated in the follow-up. All patients had obstructive sleep apnea syndrome.
Intervention
Uvulopalatopharyngoplasty.
Main Outcome Measures
Symptoms and apnea-hypopnea index (AHI) before and after UPPP. Response to treatment defined as a 50% or more reduction in AHI and a postoperative AHI of 10 or less.
Results
Reduced prevalence of snoring and daytime sleepiness and reduction in AHI (mean [±SD], 40 ±26 to 21±21) at follow-up (P<.001). Sixteen patients (64%) were responders after 6 months and 12 (48%) at the long-term follow-up. Responders had a lower preoperative AHI (25±7) than did nonresponders (48±29) (P<.05). None of the 7 patients with preoperative AHI of more than 40 were responders (P<.01). No difference was seen in preoperative body mass index, lung function, ventilatory response to carbon dioxide, computed tomography scan of upper airways, or change in body mass index between responders and nonresponders.
Conclusions
Four to 8 years after UPPP, about half of our patients were clinically and objectively improved. Uvulopalatopharyngoplasty should be reserved for patients with mild or moderate obstructive sleep apnea. After UPPP, long-term follow-up is recommended because some initially successfully treated patients will relapse in the long term.
Arch Otolaryngol Head Neck Surg. 1997;123:257-262
Author Affiliations
From the Departments of Lung Medicine (Drs Janson, Lindberg, and Boman), Psychiatry (Sleep Unit) (Drs Bengtsson and Hetta and Mr Eriksson), and Otolaryngology (Drs Lindholm and Hultcrantz), Akademiska sjukhuset, Uppsala, Sweden; the Department of Public Health Medicine, United Medical and Dental Schools, St Thomas' Hospital, London, England (Dr Janson); and the Department of Lung Medicine, Vifilsstadir Hospital, Gardabaer, Iceland (Dr Gislason).
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