Article
Upper Airway Changes in Obstructive Sleep Apnea Patients with Small Tonsils after Velopharyngeal Surgery
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Published: | April 4, 2012 |
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Outline
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Objective: The purpose of this study was to explore the relationship between anatomical changes and treatment response in obstructive sleep apnea (OSA) patients with small tonsils (tonsil grades 0-2 according to Frideman staging system) after velopharyngeal surgery.
Methods: Pre- and post-operative 3-dimensional computed tomographic (3-D CT) and polysomnography (PSG) data of 36 OSA patients who underwent velopharyngeal surgery were reviewed and measured, the surgery included revised uvulopalatopharyngoplasty with uvula preservation (H-UPPP) and concomitant transpalatal advancement pharyngoplasty.
Results: Overall apnea-hypopnea index (AHI) decreased from 56.8 (37.5, 70.1) to 16.1 (10.8, 33.5) (p<0.001) after surgery. The changes of several anatomical parameters differed significantly between responders and non-responders (p<0.05), and the change of minimal cross-sectional area of velopharynx (VmCSA) was independently predictive of the change of AHI (p<0.001, R square = 0.271). The correlation analysis showed that the change of VmCSA significantly correlated with preoperative VmCSA (r =-0.383, p = 0.021).
Conclusion: The results of this study suggested that in patients with small tonsils an increase in VmCSA is related to a good surgical response, and patients who have a relative smaller preoperative VmCSA are more likely to get favorable anatomical changes after surgery.