title: Efficacy of single-staged modified uvulopalatopharyngoplasty with nasal surgery in adults with obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  The aim of this study was to investigate the clinical efficacy of single-staged modified uvulopalatopharyngoplasty (UPPP) with nasal surgery and the relationship between its surgical outcomes and an anatomy-based staging system in patients with obstructive sleep apnea syndrome (OSAS) with nasal obstruction.
  
  
  METHODS
  Before-after analysis at a university hospital.
  
  
  METHODS
  A total of 41 consecutive OSAS patients (mean age 40.1 ± 7.3 years) who underwent single-staged modified (uvula-preserving) UPPP with nasal surgery were included. The investigators compared subjective symptoms and polysomnographic data before and after surgery and investigated objective surgical outcomes according to the anatomy-based (Friedman) staging system and postoperative complications. Surgical success was defined as a reduction of at least 50% in preoperative apnea-hypopnea index (AHI) and a postoperative AHI of less than 20 per hour.
  
  
  RESULTS
  After simultaneous nasal-oropharyngeal surgery, the AHI significantly decreased (from 45.9 ± 23.4 to 20.9 ± 22.1 events per hour; P < .001) and the overall success rate was 56.1% (23/41). Surgical success rates in stages I, II, and III were 70.6% (12/17), 60.0% (9/15), and 22.2% (2/9), respectively. There were no major complications during or after surgery, and most minor complications were transient and resolved without morbidity.
  
  
  CONCLUSIONS
  Single-staged modified UPPP with nasal surgery is an available and relatively safe surgical approach in OSAS patients with nasal obstruction. To achieve the best possible surgical outcomes, it is important to select appropriate patients using the anatomy-based staging system.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Ji Ho
authors.initials: JH
authors.lastname: Choi
authors.forename: Eun Joong
authors.initials: EJ
authors.lastname: Kim
authors.forename: Woo Sung
authors.initials: WS
authors.lastname: Cho
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: June
authors.initials: J
authors.lastname: Choi
authors.forename: Soon Young
authors.initials: SY
authors.lastname: Kwon
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Kim
authors.forename: Heung Man
authors.initials: HM
authors.lastname: Lee
authors.forename: Sang Hag
authors.initials: SH
authors.lastname: Lee
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Lee
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures; D010160:Palate, Soft / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D017286:Polysomnography; D019651:Plastic Surgery Procedures / Q000379:methods*; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery*