title: Efficacy of endoscopic static pressure/area assessment of the passive pharynx in predicting uvulopalatopharyngoplasty outcomes.
abstract: OBJECTIVE
  Although uvulopalatopharyngoplasty (UPPP) is an attractive surgical treatment for obstructive sleep apnea (OSA), the unpredictable outcome limits application of the procedure. Since UPPP corrects only retropalatal airway (RP) patency, we hypothesized that response to UPPP is determined by collapsibility of the retroglossal airway (RG), where UPPP does not correct.
  
  
  METHODS
  We estimated closing pressure (Pclose) for each pharyngeal segment by endoscopically obtaining the static pressure/area relationship of the passive pharynx in completely paralyzed and anesthetized patients with sleep-disordered breathing (n = 41) before UPPP. Preferable response to UPPP was defined as the number of oxygen dips (ODI), obtained by nocturnal oximetry, less than 10 h(-1) after UPPP.
  
  
  RESULTS
  Patients with negative Pclose at RG responded to UPPP significantly better than those with positive Pclose at RG (22/30 [73%] vs. 3/11 [27%], P<.05). ODI after UPPP was significantly correlated with age, Pclose at RP, and Pclose at RG.
  
  
  CONCLUSIONS
  Endoscopic assessment of anatomic abnormality of the pharynx in paralyzed patients with sleep-disordered breathing under general anesthesia has clinical value for the improvement of UPPP outcome.
authors.affiliation: Department of Anesthesiology, Chiba University School of Medicine, Japan. isonos@ho.chiba-u.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Isono
authors.forename: A
authors.initials: A
authors.lastname: Shimada
authors.forename: A
authors.initials: A
authors.lastname: Tanaka
authors.forename: Y
authors.initials: Y
authors.lastname: Tagaito
authors.forename: M
authors.initials: M
authors.lastname: Utsugi
authors.forename: A
authors.initials: A
authors.lastname: Konno
authors.forename: T
authors.initials: T
authors.lastname: Nishino
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy; D006801:Humans; D008875:Middle Aged; D010614:Pharynx / Q000503:physiopathology*; D011312:Pressure; D011379:Prognosis; D012891:Sleep Apnea Syndromes / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery*