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Long-term Survival After Uvulopalatopharyngoplasty in Nonobese Heavy Snorers
A 5- to 9-Year Follow-up of 400 Consecutive Patients
Michael Lysdahl, MD;
Per-Olle Haraldsson, MD, PhD
Arch Otolaryngol Head Neck Surg. 2000;126:1136-1140.
Background Heavy snoring and the obstructive sleep apnea syndrome are associated with increased morbidity and mortality in patients with cardiovascular disease. The effect of uvulopalatopharyngoplasty on mortality has been questioned.
Objective To investigate long-term survival after palatal surgery.
Design An observational retrospective case-control study with a 5- to 9-year follow-up.
Setting A university medical center.
Patients Four hundred consecutive heavy snorers (median age, 47 years), 256 of whom had obstructive sleep apnea syndrome. The mean ± SD body mass index (calculated as weight in kilograms divided by the square of height in meters) of all included patients was 27.1 ± 4.2. Comparison was made with 744 control patients (median age, 43 years) who underwent nasal surgery during the same period and a matched general control population.
Intervention Uvulopalatopharyngoplasty or laser uvulopalatoplasty between 1986 and 1990.
Main Outcome Measures Mortality and causes of death up to 9 years after surgery.
Results High blood pressure at the time of surgery and subsequent death due to cardiovascular disease were 3 times more frequent in the patients with obstructive sleep apnea syndrome than in both control groups (P<.01), but the overall long-term mortality was not increased either in snorers or in persons with sleep apnea. The cumulative survival rate was more than 96% for the 400 patients, the 744 controls, and the matched general population.
Conclusions No increased mortality was seen following palatal surgery in this long-term follow-up of 400 consecutive, on average, nonobese snorers, 256 of whom had obstructive sleep apnea syndrome. This might indicate a positive survival effect of surgery.
From the Respiratory Unit, Division of Anaesthesia and Intensive Care, Danderyd Hospital, Danderyd (Dr Lysdahl), and the Department of Otorhinolaryngology Head & Neck Surgery, Karolinska Hospital, Stockholm (Dr Haraldsson), Sweden.
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