title: Effect of uvulopalatopharyngoplasty on positional dependency in obstructive sleep apnea.
abstract: OBJECTIVE
  To assess the effect of uvulopalatopharyngoplasty (UPPP) on positional dependency in patients with obstructive sleep apnea (OSA).
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Tertiary care university hospital.
  
  
  METHODS
  Ninety-six patients who underwent UPPP because of OSA from June 1, 2004, through July 31, 2008, were included. Both preoperative and postoperative attended full-night polysomnography were conducted in all patients. Positional dependency was diagnosed if the patient's apnea-hypopnea index score in the supine position was more than twice as high as that in the lateral position.
  
  
  METHODS
  Position-specific outcomes of UPPP, such as the success rates in the supine or lateral position, were assessed, as well as overall treatment outcomes. The outcomes were also analyzed according to the severity level of the apnea-hypopnea index in each position. The change of positional dependency after UPPP was evaluated.
  
  
  RESULTS
  The apnea-hypopnea index score in the lateral position was markedly reduced after UPPP in position-independent patients (P = .02). However, the overall success rates were only 31.8% and 34.6% in patients with and without positional dependency, respectively. The success rate in the lateral position was 68.2% in position-independent patients and 32.7% in position-dependent patients (P = .01). In addition, 14 of 22 patients with position-independent OSA (64%) gained positional dependency after UPPP.
  
  
  CONCLUSIONS
  Uvulopalatopharyngoplasty is successful treatment for obstructive events occurring in the lateral sleep position, especially in patients without positional dependency. This implies that patients who have become position dependent may benefit from positional therapy after UPPP.
authors.affiliation: Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Goomi-dong, Bundang-gu, Seongnam, Gyunggi-do 463-707, South Korea.
authors.forename: Chul Hee
authors.initials: CH
authors.lastname: Lee
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Kim
authors.forename: Kyuhee
authors.initials: K
authors.lastname: Han
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Shin
authors.forename: Sung-Lyong
authors.initials: SL
authors.lastname: Hong
authors.forename: Ji-Eun
authors.initials: JE
authors.lastname: Lee
authors.forename: Chae-Seo
authors.initials: CS
authors.lastname: Rhee
authors.forename: Jeong-Whun
authors.initials: JW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010160:Palate, Soft / Q000503:physiopathology / Q000601:surgery*; D010614:Pharynx / Q000503:physiopathology / Q000601:surgery*; D017286:Polysomnography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016683:Supine Position / Q000502:physiology*; D016896:Treatment Outcome; D014609:Uvula / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult