title: Tongue-base suspension in conjunction with uvulopalatopharyngoplasty for treatment of severe obstructive sleep apnea: long-term follow-up results.
abstract: OBJECTIVE
  To evaluate the usefulness of tongue-base suspension (TBS) in addition to uvulopalatopharyngoplasty (UPPP) in the treatment of obstructive sleep apnea syndrome (OSAS).
  
  
  METHODS
  Long-term prospective case series.
  
  
  METHODS
  University tertiary care medical center.
  
  
  METHODS
  Fifty-five consecutive patients with severe OSAS (apnea-hypopnea index [AHI] 52.8+/-14.9 events/hr) with multilevel upper airway obstruction who refused treatment with continuous positive airway pressure underwent UPPP plus TBS with the Repose system. All patients were evaluated before surgery by clinical history, Epworth Sleepiness Scale (ESS), fiberoptic nasopharyngoscopy with Müller maneuver, and nocturnal polysomnography (PSG). After 3 years of surgery, all patients were re-evaluated at the clinic and had ESS test and full PSG. Surgical success was defined when the ESS dropped bellow 11, and the AHI decreased below the threshold of 20 events per hour of sleep and at least 50% from the preoperative value
  
  
  RESULTS
  There were 42 (78%) patients in which the AHI score decreased more than 50%, the AHI was lower than 20 events/hr in the PSG, and the ESS was lower than 11 after 3-years of follow-up (surgical success index). Logistic regression analysis demonstrated that body mass index at baseline was the only variable with significant statistical power to predict surgical success (odds ratio 0.85; 0.73-0.95, 95% confidence interval, P<.01)
  
  
  CONCLUSIONS
  When associated with UPPP, the TBS technique performed with the Repose system demonstrates a surgical success of up to 78% for patients with severe OSA who refused nasal continuous positive airway pressure.
authors.affiliation: ENT Department, Hospital Universitario Miguel Servet, Zaragoza, Spain. evicenteg@seorl.net
authors.forename: Eugenio
authors.initials: E
authors.lastname: Vicente
authors.forename: José M
authors.initials: JM
authors.lastname: Marín
authors.forename: Santiago
authors.initials: S
authors.lastname: Carrizo
authors.forename: M J
authors.initials: MJ
authors.lastname: Naya
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010614:Pharynx / Q000601:surgery*; D017286:Polysomnography; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D014059:Tongue / Q000601:surgery*; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery*