Uvulopalatopharyngoplasty in the management of obstructive sleep apnea: The mayo clinic experience

Akram Khan, Kannan Ramar, Supriya Khan, Oren Friedman, John F. Pallanch, Eric J. Olson

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To assess the role of uvulopalatopharyngoplasty (UPPP) in the treatment of obstructive sleep apnea (OSA) using polysomnography (PSG) data within 6 months before and after surgery. PATIENTS AND METHODS: We analyzed PSG and body mass index (BMI) data from patients with OSA who were 18 years or older and who underwent UPPP between January 1, 1988, and August 31, 2006. RESULTS: Sixty-three patients (51 men [81.0%]; mean ± SD age, 42.1±13.9 years; mean ± SD BMI, 34.9±7.2) underwent PSG a mean ± SD of 50±47 days before and 88.5±34.0 days after UPPP. Surgical cure was defined as a postoperative apnea-hypopnea index (AHI) of 5 or less. Fifteen patients (24%) achieved a surgical cure. Twenty-one patients (33%) had a postoperative AHI of 10 or less, whereas 32 (51%) achieved a 50% or greater reduction in AHI and/or an AHI of 20 or less. No significant changes were noted in BMI before and 6 months after UPPP. Patients who attained an AHI of 5 or less were younger (mean ± SD age, 35.9±13.1 vs 44±13.7 years; P=.05), had lower BMIs (mean ± SD, 30.8±6.5 vs 34.6±6.6; P=.05), and had less severe OSA (mean ± SD AHI, 38.1±33.6 vs 69.6±32.8; P=.004). Of the 48 patients (76%) with a post-UPPP AHI greater than 5, 35 (56%) received continuous positive airway pressure, with a mean reduction in pressure of 1.4 cm H2O (95% confidence interval, -0.4 to -2.4 cm H2O). CONCLUSION: Independent of changes in BMI, in our retrospective analysis, UPPP achieved an AHI of 5 or less in 24% and an AHI of 10 or less in 33% of patients with OSA who underwent PSG 6 months before and after surgery. In those with residual OSA who received continuous positive airway pressure, the required pressure setting decreased by 1.4 cm H 2O.

Original languageEnglish (US)
Pages (from-to)795-800
Number of pages6
JournalMayo Clinic Proceedings
Volume84
Issue number9
DOIs
StatePublished - 2009

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Obstructive Sleep Apnea
Apnea
Polysomnography
Body Mass Index
Continuous Positive Airway Pressure
Pressure
Confidence Intervals

ASJC Scopus subject areas

  • Medicine(all)

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Uvulopalatopharyngoplasty in the management of obstructive sleep apnea : The mayo clinic experience. / Khan, Akram; Ramar, Kannan; Khan, Supriya; Friedman, Oren; Pallanch, John F.; Olson, Eric J.

In: Mayo Clinic Proceedings, Vol. 84, No. 9, 2009, p. 795-800.

Research output: Contribution to journalArticle

Khan, Akram ; Ramar, Kannan ; Khan, Supriya ; Friedman, Oren ; Pallanch, John F. ; Olson, Eric J. / Uvulopalatopharyngoplasty in the management of obstructive sleep apnea : The mayo clinic experience. In: Mayo Clinic Proceedings. 2009 ; Vol. 84, No. 9. pp. 795-800.
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title = "Uvulopalatopharyngoplasty in the management of obstructive sleep apnea: The mayo clinic experience",
abstract = "OBJECTIVE: To assess the role of uvulopalatopharyngoplasty (UPPP) in the treatment of obstructive sleep apnea (OSA) using polysomnography (PSG) data within 6 months before and after surgery. PATIENTS AND METHODS: We analyzed PSG and body mass index (BMI) data from patients with OSA who were 18 years or older and who underwent UPPP between January 1, 1988, and August 31, 2006. RESULTS: Sixty-three patients (51 men [81.0{\%}]; mean ± SD age, 42.1±13.9 years; mean ± SD BMI, 34.9±7.2) underwent PSG a mean ± SD of 50±47 days before and 88.5±34.0 days after UPPP. Surgical cure was defined as a postoperative apnea-hypopnea index (AHI) of 5 or less. Fifteen patients (24{\%}) achieved a surgical cure. Twenty-one patients (33{\%}) had a postoperative AHI of 10 or less, whereas 32 (51{\%}) achieved a 50{\%} or greater reduction in AHI and/or an AHI of 20 or less. No significant changes were noted in BMI before and 6 months after UPPP. Patients who attained an AHI of 5 or less were younger (mean ± SD age, 35.9±13.1 vs 44±13.7 years; P=.05), had lower BMIs (mean ± SD, 30.8±6.5 vs 34.6±6.6; P=.05), and had less severe OSA (mean ± SD AHI, 38.1±33.6 vs 69.6±32.8; P=.004). Of the 48 patients (76{\%}) with a post-UPPP AHI greater than 5, 35 (56{\%}) received continuous positive airway pressure, with a mean reduction in pressure of 1.4 cm H2O (95{\%} confidence interval, -0.4 to -2.4 cm H2O). CONCLUSION: Independent of changes in BMI, in our retrospective analysis, UPPP achieved an AHI of 5 or less in 24{\%} and an AHI of 10 or less in 33{\%} of patients with OSA who underwent PSG 6 months before and after surgery. In those with residual OSA who received continuous positive airway pressure, the required pressure setting decreased by 1.4 cm H 2O.",
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T1 - Uvulopalatopharyngoplasty in the management of obstructive sleep apnea

T2 - The mayo clinic experience

AU - Khan, Akram

AU - Ramar, Kannan

AU - Khan, Supriya

AU - Friedman, Oren

AU - Pallanch, John F.

AU - Olson, Eric J.

PY - 2009

Y1 - 2009

N2 - OBJECTIVE: To assess the role of uvulopalatopharyngoplasty (UPPP) in the treatment of obstructive sleep apnea (OSA) using polysomnography (PSG) data within 6 months before and after surgery. PATIENTS AND METHODS: We analyzed PSG and body mass index (BMI) data from patients with OSA who were 18 years or older and who underwent UPPP between January 1, 1988, and August 31, 2006. RESULTS: Sixty-three patients (51 men [81.0%]; mean ± SD age, 42.1±13.9 years; mean ± SD BMI, 34.9±7.2) underwent PSG a mean ± SD of 50±47 days before and 88.5±34.0 days after UPPP. Surgical cure was defined as a postoperative apnea-hypopnea index (AHI) of 5 or less. Fifteen patients (24%) achieved a surgical cure. Twenty-one patients (33%) had a postoperative AHI of 10 or less, whereas 32 (51%) achieved a 50% or greater reduction in AHI and/or an AHI of 20 or less. No significant changes were noted in BMI before and 6 months after UPPP. Patients who attained an AHI of 5 or less were younger (mean ± SD age, 35.9±13.1 vs 44±13.7 years; P=.05), had lower BMIs (mean ± SD, 30.8±6.5 vs 34.6±6.6; P=.05), and had less severe OSA (mean ± SD AHI, 38.1±33.6 vs 69.6±32.8; P=.004). Of the 48 patients (76%) with a post-UPPP AHI greater than 5, 35 (56%) received continuous positive airway pressure, with a mean reduction in pressure of 1.4 cm H2O (95% confidence interval, -0.4 to -2.4 cm H2O). CONCLUSION: Independent of changes in BMI, in our retrospective analysis, UPPP achieved an AHI of 5 or less in 24% and an AHI of 10 or less in 33% of patients with OSA who underwent PSG 6 months before and after surgery. In those with residual OSA who received continuous positive airway pressure, the required pressure setting decreased by 1.4 cm H 2O.

AB - OBJECTIVE: To assess the role of uvulopalatopharyngoplasty (UPPP) in the treatment of obstructive sleep apnea (OSA) using polysomnography (PSG) data within 6 months before and after surgery. PATIENTS AND METHODS: We analyzed PSG and body mass index (BMI) data from patients with OSA who were 18 years or older and who underwent UPPP between January 1, 1988, and August 31, 2006. RESULTS: Sixty-three patients (51 men [81.0%]; mean ± SD age, 42.1±13.9 years; mean ± SD BMI, 34.9±7.2) underwent PSG a mean ± SD of 50±47 days before and 88.5±34.0 days after UPPP. Surgical cure was defined as a postoperative apnea-hypopnea index (AHI) of 5 or less. Fifteen patients (24%) achieved a surgical cure. Twenty-one patients (33%) had a postoperative AHI of 10 or less, whereas 32 (51%) achieved a 50% or greater reduction in AHI and/or an AHI of 20 or less. No significant changes were noted in BMI before and 6 months after UPPP. Patients who attained an AHI of 5 or less were younger (mean ± SD age, 35.9±13.1 vs 44±13.7 years; P=.05), had lower BMIs (mean ± SD, 30.8±6.5 vs 34.6±6.6; P=.05), and had less severe OSA (mean ± SD AHI, 38.1±33.6 vs 69.6±32.8; P=.004). Of the 48 patients (76%) with a post-UPPP AHI greater than 5, 35 (56%) received continuous positive airway pressure, with a mean reduction in pressure of 1.4 cm H2O (95% confidence interval, -0.4 to -2.4 cm H2O). CONCLUSION: Independent of changes in BMI, in our retrospective analysis, UPPP achieved an AHI of 5 or less in 24% and an AHI of 10 or less in 33% of patients with OSA who underwent PSG 6 months before and after surgery. In those with residual OSA who received continuous positive airway pressure, the required pressure setting decreased by 1.4 cm H 2O.

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