The Efficacy of Anatomically Based Multilevel Surgery for Obstructive Sleep Apnea

OBJECTIVE: Most reports in the literature focus on the efficacy of a single procedure for obstructive sleep apnea (OSA). We review the overall efficacy of a surgical methodology based on localizing the level of anatomic obstruction for each patient and surgical correction of the nasal, oropharyngeal...

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Bibliographic Details
Published in:Otolaryngology-head and neck surgery 2003-10, Vol.129 (4), p.327-335
Main Authors: Kao, Yi H., Shnayder, Yelizaveta, Lee, Kelvin C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Body Mass Index
Body Weight
Disorders of Excessive Somnolence - epidemiology
Female
Humans
Hypopharynx - anatomy & histology
Hypopharynx - surgery
Male
Middle Aged
Oropharynx - anatomy & histology
Oropharynx - surgery
Otorhinolaryngologic Surgical Procedures - methods
Positive-Pressure Respiration - methods
Postoperative Care
Preoperative Care
Retrospective Studies
Severity of Illness Index
Sleep Apnea, Obstructive - epidemiology
Sleep Apnea, Obstructive - surgery
Sleep Apnea, Obstructive - therapy
Snoring - diagnosis
Snoring - epidemiology
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Summary:OBJECTIVE: Most reports in the literature focus on the efficacy of a single procedure for obstructive sleep apnea (OSA). We review the overall efficacy of a surgical methodology based on localizing the level of anatomic obstruction for each patient and surgical correction of the nasal, oropharyngeal, or hypopharyngeal obstruction. STUDY DESIGN AND SETTING: Retrospective review of cases performed by a single practitioner using a systematic approach to surgery for OSA with pre-operative and postoperative sleep studies. RESULTS: Forty-two patients with a respiratory disturbance index (RDI) greater than 15 were included in the study. Surgery involved at least 2 levels of obstruction usually performed in 2 stages. All patients reported symptomatic improvement. Overall, 83.3% (35 of 42) of patients were cured according to the accepted RDI criteria of more than 50% reduction and final RDI of less than 20. All 21 patients with mild OSA (RDI, 50) were cured. CONCLUSION: The use of an anatomically based methodology in approaching patients with OSA seems to offer a higher efficacy than a single procedure as reported in the literature. (Otolaryngol Head Neck Surg 2003;129:327–35.)
ISSN:0194-5998
1097-6817
DOI:10.1016/S0194-59980300711-3