Predictors of uvulopalatopharyngoplasty success in the treatment of obstructive sleep apnea syndrome

Abstract Objective Uvulopalatopharyngoplasty (UPPP) has been described as an option for treating obstructive sleep apnea syndrome (OSAS), with variable success rates. The main purpose of our study was to correlate UPPP success to craniofacial bony structure and orofacial muscles function. Methods Cl...

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Bibliographic Details
Published in:Sleep medicine 2013-12, Vol.14 (12), p.1266-1271
Main Authors: Braga, Adriano, Grechi, Taís H, Eckeli, Alan, Vieira, Bruno B, Itikawa, Carla E, Küpper, Daniel S, Matsumoto, Mirian A.N, Trawitzki, Luciana V.V, Felício, Cláudia M, Fernandes, Regina M.F, Valera, Fabiana C.P
Format: Article
Language:English
Subjects:
Adult
Cephalometry
Dynamometer
Facial Bones - physiology
Facial Muscles - physiology
Humans
Hyoid
Hyoid Bone - physiology
Middle Aged
Muscle strength
Muscle Strength Dynamometer
Neurology
Obstructive sleep apnea
Palate - physiopathology
Palate - surgery
Pharynx - physiopathology
Pharynx - surgery
Polysomnography
Postoperative Period
Predictive Value of Tests
Reconstructive Surgical Procedures - methods
Sleep apnea syndrome
Sleep Apnea, Obstructive - physiopathology
Sleep Apnea, Obstructive - surgery
Sleep Medicine
Tongue
Tongue - physiopathology
Treatment Outcome
Uvula - surgery
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Summary:Abstract Objective Uvulopalatopharyngoplasty (UPPP) has been described as an option for treating obstructive sleep apnea syndrome (OSAS), with variable success rates. The main purpose of our study was to correlate UPPP success to craniofacial bony structure and orofacial muscles function. Methods Clinical variables, including body mass index (BMI), age, and preoperative apnea-hypopnea index (AHI); cephalometric measurements of the craniofacial region and hyoid bone position; and muscle function variables including clinical protocol and tongue strength measures were evaluated in 54 patients who underwent UPPP in the last 7 years. The measurements were related to the success or failure of UPPP based on the results of preoperative and postoperative polysomnography (PSG). Results The variables BMI, preoperative AHI, and cephalometric measurements showed no influence on surgical success. The clinical muscle protocol also was similar between groups. However, the muscle strength of the anterior portion of the tongue was significantly greater in the group that showed surgical success compared to those with surgical failure. Conclusion OSAS is a multifactorial disease and diagnostic symptom assessments should be individualized. In addition, special attention should be given to functional muscle alterations of the airways, as they might influence the evolution of the disease.
ISSN:1389-9457
1878-5506
DOI:10.1016/j.sleep.2013.08.777