This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (6)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Quality of Life  • Sleep Apnea  • Alert me on articles by topic

Hsueh-Yu Li, MD; Ning-Hung Chen, MD; Yu-Hsiang Shu, MSc; Pa-Chun Wang, MD, MSc

Arch Otolaryngol Head Neck Surg. 2004;130:195-200.

Objective  To evaluate the subjective and objective outcomes of extended uvulopalatal flap (EUPF) surgery in patients with obstructive sleep apnea.

Design  Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Snore Outcomes Survey (SOS), Epworth Sleepiness Scale (ESS), and polysomnography were performed preoperatively and then 6 months postoperatively.

Setting  Tertiary care, sleep disorders referral center.

Patients  Fifty-five consecutive patients (52 men and 3 women; mean age, 45 years) with obstructive sleep apnea.

Intervention  EUPF surgery.

Main Outcome Measures  Overnight polysomnography variables included respiratory distress index (RDI), snore index, minimum oxygen saturation, sleep stages 1 and 2, sleep stages 3 and 4, rapid eye movement, and sleep efficiency. Questionnaire variables included SF-36, SOS, and ESS scores. Success of the operation was defined as a more than 50% reduction of the RDI from the initial value and a postoperative RDI of less than 20.

Results  The overall success rate of the EUPF surgery was 82%; the RDI, snore index, and minimum oxygen saturation improved significantly after surgery (P<.001). Sleep architecture in overnight polysomnography remained unchanged (P = .48 and P = .74). Patients demonstrated significant improvement in both their SOS and ESS scores (P<.001) and significant increases in 7 of 8 SF-36 subscales (P<.05 for all). However, there was poor correlation between the improvement in quality of life and the reduction in sleep-related respiratory events.

Conclusions  Extended uvulopalatal flap surgery can greatly reduce sleep-related adverse events and proves to be an effective therapy to enhance the quality of life of patients with obstructive sleep apnea. This study also suggests that subjective and objective outcomes are equally important when reporting the results of EUPF surgery.

From the Departments of Otolaryngology (Dr Li) and Pulmonary and Critical Care Medicine (Dr Chen), Sleep Center, Chang Gung Memorial Hospital, Taipei, Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei (Mr Shu), and Department of Otolaryngology, Cathay General Hospital, Taipei, and Department of Public Health, China Medical University, Taichung (Dr Wang), Taiwan. The authors have no relevant financial interest in this article.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Surgical Treatment of Obstructive Sleep Apnea: Upper Airway and Maxillomandibular Surgery
Won et al.
Proc Am Thorac Soc 2008;5:193-199.
ABSTRACT | FULL TEXT  

Eucapnic intermittent hypoxia augments endothelin-1 vasoconstriction in rats: role of PKC{delta}
Allahdadi et al.
Am. J. Physiol. Heart Circ. Physiol. 2008;294:H920-H927.
ABSTRACT | FULL TEXT