LUPP relieves partial upper airway obstruction during sleep in patients with velopharyngeal narrowing.
CONCLUSIONS
Patients with upper airway narrowing at the soft palate level and partial upper airway obstruction during sleep seem to benefit from laser-assisted uvulopalatoplasty (LUPP) in terms of decreased velopharyngeal collapsibility and improved nocturnal breathing.


OBJECTIVE
The current operative treatments for obstructive sleep apnea syndrome (OSAS) are not very effective compared with continuous positive airway pressure (CPAP). It has been suggested that active treatment should be performed earlier, when sleep apnea is present in a milder form. The main problem is identifying progressive sleep apnea. The present study assessed the efficacy of LUPP in patients with partial upper airway obstruction during sleep diagnosed by means of a static charge-sensitive bed (SCSB) combined with oxyhemoglobin desaturation recording and digital fluoroscopy-based collapsibility estimation.


METHODS
LUPP was carried out in 27 patients under local anesthesia as day surgery. Digital fluoroscopy and SCSB were recorded preoperatively and 6 months after LUPP.


RESULTS
Partial upper airway obstruction events and arterial oxyhemoglobin desaturations during sleep decreased significantly. Digital fluoroscopy revealed that the minimal anteroposterior dimension increased and collapsibility decreased at the level where velopharyngeal obstruction occurred, the soft palate.
Halme
Perttu
P
Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital, Turku, Finland. perhal@utu.fi
Toskala
Elina
E
Laurikainen
Esa
E
Antila
Jukka
J
Tsushima
Yoshito
Y
Polo
Olli
O
D000328:Adult; D000402:Airway Obstruction / Q000601:surgery; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D010160:Palate, Soft / Q000601:surgery*; D020181:Sleep Apnea, Obstructive / Q000601:surgery*