[Clinical and functional analysis of long-term results of uvulopalatopharyngoplasty].
In order to evaluate the clinical and functional effectiveness of uvulopalatopharyngoplasty (UPPP) in chronic roncopathy, we studied the subjective improvement of operated patients and compared to pulsioximetry findings before and after surgery. A follow-up was made on 72 patients entitled of chronic roncopathy--51 with obstructive sleep apnea syndrome (OSAS) and 21 with simple snoring-, for a mean period of time of 41 months. Preoperatory study included on ENT exploration, fibre optic endoscopy, Müller maneuver, pharyngeal CT, value of daytime sleepiness with Epworth's scale, espirometry and pulsioximetry, and the postoperatory study included of pulsioximetry and a health questionnaire over snoring and daytime sleepiness. Snoring improved or disappeared in 13 of 21 patients (61.8%), and daytime sleepiness did it in 26 of 39 (66.6%). Therapeutic failure in snoring was mainly due to an increase in the body mass index. After UPPP in OSAS, only 21 patients (41.1%) showed all positive response criteria (decrease into ODI > or = 50% or in absolute values < 6, CT 90% < 1%, and SaO2 Min > or = 85%). UPPP failed in long term evaluation in the rest of individuals. Patient selection is mandatory to optimize clinical response of UPPP for snoring, without OSAS success depends on body mass index, respiratory disturbances ratios and the eventual presence of another upper airways collapses below velopharyngeal segment.
Servicio de ORL, Hospital Clínico Universitario, Valencia.
E
E
Fernández Julián
M
M
Esparcia Navarro
F J
FJ
García Callejo
M H
MH
Orts Alborch
A
A
Morant Ventura
L
L
de la Fuente
F
F
Sánchez
J
J
Marco Algarra
D000328:Adult; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010160:Palate, Soft / Q000601:surgery*; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications; D012913:Snoring / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D011795:Surveys and Questionnaires; D013995:Time; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery*