Surgery and obstructive sleep apnea: long-term clinical outcomes.
OBJECTIVE
Outcome data on the surgical treatment of obstructive sleep apnea are, in general, based on short-term follow-up (<6-9 months). This examination was undertaken to assess long-term results.


METHODS
Forty patients who underwent soft tissue and skeletal surgery were the subjects of this review. Methods of evaluation included polysomnographic variables (respiratory disturbance index [RDI], low oxyhemoglobin desaturation [LSAT]), body mass index, quality-of-life assessments, roentgenographic analysis, and complications. Statistical analysis used the SAS 6.12 system.


RESULTS
Thirty-six of 40 patients (90%) showed long-term clinical success. The mean preoperative RDI, nasal continuous positive airway pressure RDI, and long-term RDI were 71.2 +/- 27.0, 7.6 +/- 5.2 and 7.6 +/- 5.1, respectively. The mean preoperative LSAT, nasal continuous positive airway pressure LSAT, and long-term LSAT were 67. 5% +/- 14.8%, 87.1% +/- 3.2%, and 86.3% +/- 3.9%, respectively. The mean follow-up was 50.7 +/- 31.9 months. The patients showed a statistically significant long-term weight gain (P = 0.0002) compared with their 6-month postoperative level (body mass index 31. 4 +/- 6.7 vs 32.2 +/- 6.3). There was a positive correlation with the amount of skeletal advancement and clinical outcome.


CONCLUSIONS
Comprehensive evaluation and surgical treatment can result in successful long-term clinical outcome.
Riley
R W
RW
Stanford University Center of Excellence in Sleep Medicine, Stanford, California, USA.
Powell
N B
NB
Li
K K
KK
Troell
R J
RJ
Guilleminault
C
C
D000328:Adult; D000368:Aged; D000403:Airway Resistance / Q000502:physiology; D015992:Body Mass Index; D002508:Cephalometry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019186:Mandibular Advancement; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D010027:Osteotomy; D010043:Outcome and Process Assessment, Health Care; D010108:Oxyhemoglobins / Q000378:metabolism; D010160:Palate, Soft / Q000601:surgery; D017286:Polysomnography; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D011788:Quality of Life; D012086:Reoperation; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000601:surgery*
D010108:Oxyhemoglobins