title: Long-term results of one staged multilevel surgery with tongue suspension surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea.
abstract: The objective of this study is to evaluate and compare the long-term efficacy of the one staged multilevel surgery (MLS) with tongue suspension (TBS) surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea (OSA). This is a prospective cross-sectional study.
  
  
  METHODS
  University hospital. Thirty-three patients diagnosed as moderate to severe OSA. Patients, with ≥ 50 % retropalopharyngeal obstruction on the Müller maneuver, were treated with palatal surgeries (PS) and patients, with ≥ 50 % retropalopharyngeal obstruction on the Müller maneuver with ≥ 50 % base of the tongue collapse, were treated with palatal surgeries and tongue suspension surgery (TBS). Patients were evaluated with one night polysomnography before the surgery and 24 months after the surgery. Patients completed Epworth sleepiness scale (ESS), snoring VAS (visual analog scale) before and 24 months after the surgery. Nine-teen patients with a mean age of 46.1 ± 8.3 underwent palatal surgeries (PS) and 14 patients with a mean age of 41.4 ± 8.9 underwent PS plus TBS. Success rate in TBS+PS group was 57.1 % and in PS group was 42.1 %. In both groups total apnea-hypopnea index (AHI) values significantly decreased after 2 years (p < 0.025) but there was no statistically significant difference between TBS+PS and PS groups. Supine AHI levels were reduced statistically significant in both groups postoperatively (p < 0.025). There was not any significant difference postoperatively in non-supine AHI levels in both groups (p > 0.025). There were significant postoperative changes in ODI, AVO2, MOS, ESS, Snoring VAS values in PS group (p < 0.025). In TBS+PS group there was a significant difference postoperatively only in ODI values. Treatment of OSA patients with retropalatal or retropalatal and retroglossal obstruction, in a one staged surgery, is a safe and easy procedure. We have achieved favorable long-term outcomes in moderate-severe OSA patients undergoing both palatal surgery and tongue suspension surgery.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Turgut Ozal University Faculty of Medicine, Ankara, Turkey. alyuksel2003@yahoo.com.|Turgut Ozal University Hospital, Alpaslan Turkes Caddesi No:57, Emek, 06510, Ankara, Turkey. alyuksel2003@yahoo.com.
authors.forename: Alper
authors.initials: A
authors.lastname: Yüksel
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Turgut Ozal University Faculty of Medicine, Ankara, Turkey.
authors.forename: Kadriye Serife
authors.initials: KS
authors.lastname: Ugur
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Siirt State Hospital, Siirt, Turkey.
authors.forename: Gultekin
authors.initials: G
authors.lastname: Kizilbulut
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Turgut Ozal University Faculty of Medicine, Ankara, Turkey.
authors.forename: Nebil
authors.initials: N
authors.lastname: Ark
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Turgut Ozal University Faculty of Medicine, Ankara, Turkey.
authors.forename: Hanifi
authors.initials: H
authors.lastname: Kurtaran
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Turgut Ozal University Faculty of Medicine, Ankara, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Kaya
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Turgut Ozal University Faculty of Medicine, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gunduz
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D010159:Palate / Q000601:surgery*; D017286:Polysomnography / Q000379:methods; D011184:Postoperative Period; D011446:Prospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D012913:Snoring / Q000175:diagnosis / Q000601:surgery; D013995:Time; D014059:Tongue / Q000601:surgery*; D016896:Treatment Outcome; D014421:Turkey
keywords: Apnea–hypopnea index; Obstructive sleep apnea (OSA); Snoring; Tongue base suspension
references.citation: J Laryngol Otol. 2002 Sep;116(9):716-21
references.pmid: 12437808
references.citation: Otolaryngol Head Neck Surg. 2006 May;134(5):856-61
references.pmid: 16647548
references.citation: Otolaryngol Head Neck Surg. 2002 Apr;126(4):392-8
references.pmid: 11997779
references.citation: Lancet. 1999 Jun 19;353(9170):2100-5
references.pmid: 10382693
references.citation: N Engl J Med. 1993 Apr 29;328(17):1230-5
references.pmid: 8464434
references.citation: Otolaryngol Head Neck Surg. 2009 Aug;141(2):253-6
references.pmid: 19643261
references.citation: Otolaryngol Head Neck Surg. 2007 Apr;136(4):626-31
references.pmid: 17418263
references.citation: Laryngoscope. 2003 Nov;113(11):1961-8
references.pmid: 14603056
references.citation: Laryngoscope. 2006 Jul;116(7):1223-7
references.pmid: 16826064
references.citation: Otolaryngol Head Neck Surg. 2001 Mar;124(3):297-303
references.pmid: 11240995
references.citation: Otolaryngol Head Neck Surg. 2003 Nov;129(5):539-46
references.pmid: 14595277
references.citation: HNO. 2008 Nov;56(11):1089-97
references.pmid: 18853128
references.citation: Laryngoscope. 1999 Dec;109(12):1901-7
references.pmid: 10591345
references.citation: Eur Arch Otorhinolaryngol. 2009 May;266(5):691-7
references.pmid: 18941765
references.citation: Otolaryngol Head Neck Surg. 2005 Aug;133(2):218-23
references.pmid: 16087018
references.citation: Otolaryngol Head Neck Surg. 2000 Jan;122(1):100-3
references.pmid: 10629491
references.citation: Eur Respir J. 2011 May;37(5):1000-28
references.pmid: 21406515
references.citation: J Oral Maxillofac Surg. 1999 Apr;57(4):382-5
references.pmid: 10199488
references.citation: Ear Nose Throat J. 1993 Jan;72(1):67-72, 75-6
references.pmid: 8444132
references.citation: Eur Arch Otorhinolaryngol. 2006 Oct;263(10):946-50
references.pmid: 16802139
references.citation: JAMA. 2000 Dec 20;284(23):3015-21
references.pmid: 11122588
references.citation: Auris Nasus Larynx. 2011 Aug;38(4):487-94
references.pmid: 21273016
references.citation: Otolaryngol Head Neck Surg. 2000 Mar;122(3):395-401
references.pmid: 10699817
references.citation: Am J Otolaryngol. 2009 Nov-Dec;30(6):401-6
references.pmid: 19880029