The effects of anterior palatoplasty on floppy eyelid syndrome patients with obstructive sleep apnea

• Published in: The Laryngoscope 2016-09, Vol.126 (9), p.2171-2175
• Main Authors: Bayır, Ömer, Acar, Mutlu, Yüksel, Elvan, Yüceege, Melike, Saylam, Güleser, Tatar, Emel Çadalli, Özdek, Ali, Firat, Hikmet, Gürdal, Canan, Korkmaz, Mehmet Hakan
• Format: Article
• Language: English
• Subjects: Adult; anterior palatoplasty; Conjunctivitis - etiology; Corneal Diseases - etiology; Double-Blind Method; Eyelid Diseases - etiology; Female; floppy eyelid syndrome; Humans; Male; Middle Aged; Obstructive sleep apnea; Palate - surgery; Prospective Studies; Severity of Illness Index; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - surgery; Surgery; Syndrome; Young Adult
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.25905

Objectives/Hypothesis To investigate the effects of anterior palatoplasty on the presence and stage of floppy eyelid syndrome (FES) among patients diagnosed with mild or moderate obstructive sleep apnea (OSA) according to the apnea‐hypopnea index (AHI). Study Design Prospective controlled trial. Methods Those patients whose AHI scores were between 5 and 30 according to full‐night polysomnography were included in the study. The patients in whom anterior palatoplasty was performed were included in the study group, whereas those refusing surgery comprised the control group. All patients were evaluated for the presence of FES. The sleep studies were repeated after the third postoperative month, and the results were statistically compared. Results Sixty‐two patients were included in the study. Thirty‐five patients who were treated with anterior palatoplasty comprised the study group, and 27 patients were included in the control group. In the surgically treated group, 60% (n = 21) had FES, whereas 55.5% (n = 15) of the control group had FES (P = .798). In the surgically treated group, the FES ratio decreased to 25.7% (n = 9) after the third postoperative month (P = .007). In surgically successful cases, the preoperative–postoperative oxygen desaturation index and preoperative–postoperative lowest oxygen saturation values were 11.755% ± 9.037% and 6.77% ± 5.362% (P = .04), and 86.1% ± 3.89% and 87.8% ± 2.85%, respectively (P = .124). These values were 12.166% ± 5.767% and 14.780% ± 9.924% (P = .385), and 86.13% ± 4.18% and 85.26% ± 4.26%, respectively (P = .579), in patients who underwent unsuccessful surgery. Conclusions FES presence and stages were decreased following successful anterior palatoplasty surgery. This effect may have resulted from the correction of tissue hypoxia, which is common in the pathophysiology of both OSA and FES. Level of Evidence 2b Laryngoscope, 126:2171–2175, 2016