Vol.95 No.8 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 95 No. 8 August 2002
Subjective and Objective Assessment of UPPP
Nobuo Usui, Kazuhiro Kawano, Koichi Ito and Madoka Ishibashi
(Toho University)
Objective: In this study, we evaluated the efficacy of uvulopalatopharyngoplasty (UPPP) in patients with obstructive sleep apnea syndrome (OSAS) both subjectively and objectively, on the basis of responses to a mailed questionnaire from subjects, as well as pre- and post-operative physiological examinations and upper respiratory magnetic resonance imaging (MRI).
Subjects and Methods: This study comprised 23 patients who had undergone UPPP during the 9-year period from 1990 to 1998, together with physiological examinations and upper respiratory MRI before and 3-6 months after the UPPP, and who responded to the mailed questionnaire. The questionnaire survey was conducted before and 43 months (mean) (±23.8; range: 13-89) after UPPP: the response rate was 64.7％.
Results: The frequency of snoring was significantly correlated with the postoperative length of the soft palate (p＜0.05), that is, the shorter the postoperative length of the soft palate, the lower the frequency of snoring became. In addition, postoperative sleep quality was found to be significantly correlated with AHI improvement rates (p＜0.05) as well as to the postoperative transverse diameter of the pharyngeal cavity (p＜0.01). In other words, sleep quality increased in parallel with the increase in AHI improvement rates as well as with the increase in the transverse diameter of the pharyngeal cavity. With regard to the degree of interference in the sleep of a bed-partner, the higher the preoperative AHI (p＜0.05), the lower the degree of interference. The degree of general satisfaction with the surgical outcome was higher among patients with higher preoperative AHI (p＜0.01).
Conclusion: These findings indicate that the length of the soft palate is associated with the frequency of snoring and that the transverse diameter of the pharyngeal cavity is related to the frequency of sleep apnea. Therefore, shortening of the soft palate and the uvula as well as lengthening the diameter of the pharyngeal cavity may be indicated as surgical treatment for snoring and sleep apnea, respectively.
Key words : UPPP, OSAS, mailed questionnaire, physiological examination, upper respiratory MRI