title: Change in position dependency in non-responders after multilevel surgery for obstructive sleep apnea: analysis of polysomnographic parameters.
abstract: This study was aimed to evaluate the change in positional dependency by analyzing polysomnographic data in non-responders who previously underwent multilevel surgery for obstructive sleep apnea. A total of 48 consecutive patients who had a <50% reduction of apnea/hypopnea index (AHI) and a postoperative AHI of ≤20 after multilevel surgery were enrolled in this study. Postoperative polysomnography (PSG) was carried out at least 6 months after surgical treatment, and both pre- and postoperative PSG data were analyzed. No significant differences were found in any of the measured polysomnographic parameters before and after multilevel surgery in non-responders. In position-dependent patients, supine AHI, non-supine AHI, supine oxygen desaturation index (ODI) and non -supine ODI did not significantly improve after surgery. However, non-supine AHI and non-supine ODI in non-position-dependent patients (NPPs) improved significantly. Ten of 15 initially NPPs had position dependency after surgery, increasing the proportion of PPs from 68.8% (33/48) to 83.3% (40/48). These results suggest that positional therapy may be a useful adjuvant therapy in non-responders with position dependency.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Korea.
authors.forename: Young Chan
authors.initials: YC
authors.lastname: Lee
authors.forename: Young Gyu
authors.initials: YG
authors.lastname: Eun
authors.forename: Seung Youp
authors.initials: SY
authors.lastname: Shin
authors.forename: Sung Wan
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011183:Postoperative Complications / Q000628:therapy; D011187:Posture; D012008:Recurrence; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D017211:Treatment Failure