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Uses and complications of uvulopalatopharyngoplasty

Published online by Cambridge University Press:  29 June 2007

Charles B. Croft*
Affiliation:
(London)
David G. Golding-Wood
Affiliation:
(London)
*
Mr C. B. Croft, F.R.C.S., Royal National Throat Nose and Ear Hospital, 330–336 Gray's Inn Road, London WC1X 8DA.

Abstract

Uvulopalatopharygoplasty has become widely performed for chronic snoring and for cases of obstructive sleep apnoea. Unfortunately this operation is not without morbidity and complications. We report our results of a prospective series of 50 patients undergoing uvulopalatopharyngoplasty with a minimum follow-up of one year. Snoring was abolished in 18 (36 per cent) and substantially reduced in the remainder. Obstructive sleep apnoea syndrome, identified in 11 patients pre-operatively, was reduced in severity in all but three. Troublesome complications were seen in 18 (36 per cent) patients, namely intermittent velopharyngeal incompetence in five (10 percent), pharyngeal dryness in 11(22 per cent) and loss of taste in five (10 per cent). One patient had nasopharyngeal stenosis requiring correction. A cautious approach to this operation is required with rigorous case selection. The importance of full assessment and careful follow-up should not be underestimated.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1990

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References

Blakely, B. W., Maisel, R. H., Mahowald, M., Ettinger, M. (1986) Sleep parameters after surgery for obstructive sleep apnea. Oolaryngology–Head and Neck Surgery, 95: 2328.CrossRefGoogle Scholar
Borowiecki, B. de B., Sassin, J. F. (1983) Surgical treatment of sleep apnea. Archives of Otolaryngology, 109: 508512.CrossRefGoogle ScholarPubMed
Brown, I. G., Bradley, T. D., Phillipson, E. A., Zamel, N., Hoffstein, V. (1985) Pharyngeal compliance in snoring subjects with and without obstructive sleep apnea. American Review of Respiratory Disease, 132: 211215.Google ScholarPubMed
Colman, M. F. (1986) Use of a nasal pharyngeal airway after palatopharyngoplasty in patients with obstructive sleep apnea. Laryngoscope, 96: 212213.CrossRefGoogle ScholarPubMed
Colman, M. F., Rice, D. H. (1985) A method of determining the correct amount of palatal resection in palatopharyngoplasty. Laryngoscope, 95: 609610.CrossRefGoogle ScholarPubMed
Conway, W., Fujita, S., Zorick, F., Sicklesteel, J., Roehrs, T., Wittig, R., Roth, T. (1985) Uvulopalatopharyngoplasty. One year follow-up. Chest, 88: 385387.CrossRefGoogle Scholar
Finkeistein, Y., Talmi, Y., Zohar, Y. (1988) Readaptation of the velopharyngeal valve following the uvulopalatopharyngoplasty operation. Plastic and Reconstructive Surgery, 82: 2027.CrossRefGoogle Scholar
Fujita, S., Conway, W. A., Zorick, F. J., Sicklesteel, J. M., Roehrs, T. A., Wittig, R. M., Roth, T. (1985) Evaluation of the effectiveness of uvulopalatopharyngoplasty. Laryngoscope, 95: 7074.Google ScholarPubMed
Ghorayeb, B. Y. (1988) Cicatricial velopharyngeal stenosis. Archives of Otolaryngology–Head and Neck Surgery, 114: 192194.CrossRefGoogle ScholarPubMed
Golding-Wood, D. G., Brockbank, M., Swanston, A., Croft, C. B. (1990) The assessment of chronic snorers. Journal of the Royal Society of Medicine, 83: 363367.CrossRefGoogle ScholarPubMed
Gordon, A. S. D., Giles, M. L., Harding, D. A., Morton, R. P. (1986) Surgery of snoring. Journal of Laryngology and Otology, 100: 12631267.CrossRefGoogle ScholarPubMed
Haponik, E. F., Smith, P. L., Bohlman, M. E., Allen, R. P., Goldman, R. P., Bleecker, E. R. (1983) Computerized tomography in obstructive sleep apnoea. Correlation of airway size with physiology during sleep and wakefulness. American Review of Respiratory Disease, 127: 221226.Google ScholarPubMed
Johnson, J. T., Sanders, M. H. (1986) Breathing during sleep immediately after uvulopalatopharyngoplasty. Laryngoscope, 96: 12361238.CrossRefGoogle ScholarPubMed
Katsantonis, G. P., Walsh, J. K., Schweitzer, P. K., Friedman, W. H. (1985) Further evaluation of uvulopharyngoplasty in the treatment of obstructive sleep apnea syndrome. Otolaryngology–Head and Neck Surgery, 93: 244250.CrossRefGoogle Scholar
Katsantonis, G. P., Friedman, W. H., Krebs, F. J., Walsh, J. K. (1987) Nasopharyngeal complications following uvulopalatopharyngoplasty. Laryngoscope, 97: 309314.CrossRefGoogle ScholarPubMed
Katsantonis, G. P., Schweitzer, P. K., Branham, G. H., Chambers, G., Walsh, J. K. (1988) Management of obstructive sleep apnea: comparison of various treatment modalities. Laryngoscope, 98: 304309.CrossRefGoogle ScholarPubMed
Kimmelman, C. P., Levine, S. B., Shore, C. T., Millman, R. P. (1985) Uvulopalatopharyngoplasty: a comparison of two techniques. Laryngoscope, 95: 14881490.CrossRefGoogle ScholarPubMed
Koskenvuo, M., Kaprio, J., Partinen, M., Lainginvainio, H., Sarna, S., Heikkila, K. (1985) Snoring as a risk factor for hypertension and angina. Lancet, 1: 893896.CrossRefGoogle ScholarPubMed
Koskenvuo, M., Kaprio, J., Telakivi, T., Partinen, M., Heikkila, K., Sarna, S. (1987) Snoring as a risk factor for ischaemic heart disease and stroke in men. British Medical Journal, 294: 1619.CrossRefGoogle ScholarPubMed
Lehmann, W. B., Pope, T. H., Hudson, W. R. (1968) Nasopharyngeal stenosis. Laryngoscope, 78: 371.Google ScholarPubMed
Lugaresi, E., Coccagna, G., Cirignotta, F. (1978) Snoring and its clinical implications. In: Sleep apnoea syndrome. (Guilleminault, C., Dement, W. C., eds), pp 1321, Alan R. Liss, New York.Google Scholar
Macaluso, R. A., Reams, C., Gibson, W. S., Vrabec, D. P., Matragrano, A. (1989) Uvulopalatopharyngoplasty: post-operative management and evaluation of results. Annals of Otology, Rhinology and Laryngology, 98: 502507.CrossRefGoogle Scholar
McGlashan, J. A., Golding-Wood, D. G. (1989) Snoring as a presenting feature of the Shy-Drager syndrome. Journal of Laryngology and Otology, 103: 610611.CrossRefGoogle ScholarPubMed
Moran, W. B., Orr, W. C. (1985) Diagnosis and management of obstructive sleep apnea. Part II. Archives of Otolaryngology, 111:650658.CrossRefGoogle ScholarPubMed
Powell, N. B., Riley, R. W., Guilleminault, C., Murcia, G. N. (1988) Obstructive sleep apnea, continuous positive airway pressure, and surgery. Otolaryngology–Head and Neck Surgery, 99: 362369.CrossRefGoogle ScholarPubMed
Sher, A. E., Thorpy, M. J., Shprintzen, R. J., Spielman, A. J., Burack, B., McGregor, P. A. (1985) Predictive value of Muller maneuver in selection of patients for uvulopalatopharyngoplasty. Laryngoscope, 95: 14831487.CrossRefGoogle ScholarPubMed
Simmons, F. B., Guilleminault, C., Miles, L. E. (1984) The palatopharyngoplasty operation for snoring and sleep apnea. An interim report. Otolaryngology–Head and Neck Surgery, 92: 375380.CrossRefGoogle ScholarPubMed
Sullivan, C. E., Berton-Jones, M., Issa, F. G., Eves, L. (1981) Reversal of obstructive sleep apnea by continuous positive airway pressure applied through the flares. Lancet, 1: 862865.CrossRefGoogle Scholar
Sullivan, C. E., Issa, F. G. (1985) Obstructive sleep apnea. Clinics in Chest Medicine, 6: 633650.CrossRefGoogle ScholarPubMed
Wetmore, S. J., Scrima, L., Snyderman, N. L., Hiller, F. C. (1986) Post-operative evaluation of sleep apnea after uvulopalatopharyngoplasty. Laryngoscope, 96: 738741.CrossRefGoogle Scholar
Wilms, D., Popovich, J., Conway, W., Fujita, S., Zorick, F. (1982) Anatomic abnormalities in obstructive sleep apnea. Annals of Otology, Rhinology and Laryngology, 91: 595596.CrossRefGoogle ScholarPubMed