 |
|
Uvulopalatopharyngoplasty vs Laser-Assisted UvulopalatoplastyAnatomical Considerations
Yehuda Finkelstein, MD;
Myra Shapiro-Feinberg, MD;
Gideon Stein, MD;
Dov Ophir, MD
Arch Otolaryngol Head Neck Surg. 1997;123(3):265-276.
Abstract
| |
Objective
To assess and compare anatomical changes in the velopharynx produced by conventional uvulopalatopharyngoplasty and by laser-assisted uvulopalatoplasty.
Design
A before-after trial of patients who underwent conventional or laser-assisted palatal surgical procedures.
Patients and Interventions
A total of 174 patients (157 men and 17 women; age range, 22-71 years; mean age, 48 years) who were suffering from heavy snoring (n=16) or obstructive sleep apnea. The first 100 consecutive patients underwent conventional uvulopalatopharyngoplasty, and the remaining 74 underwent 1 of 2 surgical variations of laser-assisted uvulopalatoplasty.
Main Outcome Measures
Preoperative and postoperative examinations included peroral photographs of the oropharynx and nasopharyngoscopic examination of the velopharyngeal valve. In 10 randomly selected patients, postoperative lateral and frontal cephalometric radiographs, enhanced with contrast media, were compared with routine preoperative radiographs.
Results
Uvulopalatopharyngoplasty results in an enlargement of the oropharynx and an increased velopharyngeal air space. Laser-assisted uvulopalatoplasty, by producing a raw surface, involves circumferential scarring, the severity of which depends on the velopharyngeal axial configuration; therefore, it can result in a diminished velopharyngeal air space and decreased distensibility.
Conclusions
From an anatomical viewpoint, laser-assisted surgery of the palate is significantly inferior to conventional uvulopalatopharyngoplasty and may even be deleterious. The results of preoperative and postoperative polysomnographic comparisons in patients who undergo laser-assisted operations should be evaluated to determine whether future laser-assisted surgery is an adequate option, even for snoring as an isolated symptom.
Arch Otolaryngol Head Neck Surg. 1997;123:265-276
Author Affiliations
From the Departments of Otolaryngology—Head and Neck Surgery (Drs Finkelstein, Stein, and Ophir) and Radiology (Dr Shapiro-Feinberg), Meir Hospital, Sapir Medical Center, Kfar Saba, Israel, and the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (Drs Finkelstein, Shapiro-Feinberg, Stein, and Ophir).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Sleep {middle dot} 9: An approach to treatment of obstructive sleep apnoea/hypopnoea syndrome including upper airway surgery
Ryan
Thorax 2005;60:595-604.
ABSTRACT
| FULL TEXT
Is There a Better Way to Do Laser-Assisted Uvulopalatoplasty?
Berger et al.
Arch Otolaryngol Head Neck Surg 2003;129:447-453.
ABSTRACT
| FULL TEXT
LAUP Reconsidered
Kern
Arch Otolaryngol Head Neck Surg 2003;129:494-495.
FULL TEXT
LAUP Reconsidered--Reply
Berger
Arch Otolaryngol Head Neck Surg 2003;129:495-495.
FULL TEXT
Laser-Assisted Uvulopalatoplasty for the Management of Obstructive Sleep Apnea: Myths and Facts
Finkelstein et al.
Arch Otolaryngol Head Neck Surg 2002;128:429-434.
ABSTRACT
| FULL TEXT
Benefit of Atrial Pacing in Sleep Apnea Syndrome
Garrigue et al.
NEJM 2002;346:404-412.
ABSTRACT
| FULL TEXT
Response to Laser-Assisted Uvuloplasty for Snoring
Hausner and Berger
Arch Otolaryngol Head Neck Surg 2002;128:92-93.
FULL TEXT
Laser-Assisted Uvulopalatoplasty for Snoring: Medium- to Long-term Subjective and Objective Analysis
Berger et al.
Arch Otolaryngol Head Neck Surg 2001;127:412-417.
ABSTRACT
| FULL TEXT
Histopathologic Changes of the Soft Palate After Laser-Assisted Uvulopalatoplasty
Berger et al.
Arch Otolaryngol Head Neck Surg 1999;125:786-790.
ABSTRACT
| FULL TEXT
Laser-Assisted Uvulopalatoplasty in Mild Obstructive Sleep Apnea
Terris and Wang
Arch Otolaryngol Head Neck Surg 1998;124:718-721.
FULL TEXT
Comparing Uvulopalatopharyngoplasty and Laser-Assisted Uvulopalatoplasty
Terris
Arch Otolaryngol Head Neck Surg 1997;123:278-279.
ABSTRACT
|
