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The effect of uvulopalatopharyngoplasty without tonsillectomy using local anaesthesia: a prospective long-term follow-up

Published online by Cambridge University Press:  29 June 2007

Elisabeth Hultcrantz*
Affiliation:
Department of Otorhinolaryngology, University Hospital, Uppsala, Sweden.
Kaarina Johansson
Affiliation:
Department of Otorhinolaryngology, University Hospital, Uppsala, Sweden.
Harriet Bengtson
Affiliation:
Department of Psychiatry, University Hospital, Uppsala, Sweden.
*
Address for correspondence: E. Hultcrantz, M.D., Ph.D., Assoc. Prof. of Otorhinolaryngology, ENT-Clinic, UAS S-751 85 Uppsala, Sweden. Fax: +46-18-555151 e-mail: [email protected]

Abstract

This paper presents the long-term effect of restricted surgery for snoring and sleep apnoea. Patients with obstructive sleep apnoea (OSAS) (19) or heavy snoring (HS) (36) were studied prospectively for five to seven years after uvulopalatopharyngoplasty without tonsillectomy performed by regular surgical technique using local anaesthesia (LUPP). Five years after surgery, 90 per cent answered a questionnaire. All OSAS patients were offered a polysomnography, and the HS patients were offered a sleep study. Eighty per cent still showed a positive effect on daytime somnolence, and 77 per cent on snoring. Sideeffects were reported by 40 per cent; most common was choking (20 per cent) the first year. Eighteen per cent had local problems such as globus sensation. The polysomnography showed that 80 per cent were still ‘responders’ with an apnoea index (AI) reduction of >50 per cent. None of the HS patients had developed OSAS. In conclusion, LUPP in selected patients with OSAS or HS has a good long-term effect. Sideeffects are common, but diminish with time.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1999

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References

Anand, V. K., Ferguson, P. W., Schoen, L. S. (1991) Obstructive sleep apnea: A comparison of continuous positive airway pressure and surgical treatment. Archives of Otolaryngology – Head and Neck Surgery 105: 382390.CrossRefGoogle ScholarPubMed
Carenfelt, C. (1991) Laser uvulopalatoplasty in the treatment of habitual snoring. Annals of Otology, Rhinology and Laryngology 100: 451454.CrossRefGoogle ScholarPubMed
Fujita, S., Conway, W. A., Zorick, F., Roth, T. (1981) Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Archives of Otolaryngology – Head and Neck Surgery 89: 923934.CrossRefGoogle Scholar
Gislason, T., Lindholm, C.-E., Almqvist, M., Birring, E., Boman, G., Eriksson, G., Larsson, S. G., Lidell, Ch., Svanholm, H. (1988a) Uvulopalatopharyngoplasty in the sleep apnea syndrome: Predictors of results. Archives of Otolaryngology – Head and Neck Surgery 144: 4551.CrossRefGoogle Scholar
Gislason, T., Almqvist, M., Eriksson, G., Taube, A., Boman, G. (1988b) Prevalence of sleep apnea syndrome among Swedish men: An epidemiological study. Journal of Clinical Epidemiology 41: 571576.CrossRefGoogle ScholarPubMed
Haraldsson, P.-O. (1991) Rhonchopathy – a treatable traffic hazard. Thesis, Karolinska Institute, Stockholm.Google Scholar
Hultcrantz, E., Boman, G., Hetta, J. (1991) Poliklinisk snarkoperation i lokalanestesi. Societas Oto-Laryngologica Svecia 1: 17.Google Scholar
Janson, C., Gislason, T., Bengtson, H., Lindberg, E., Lindholm, C.-E., Hultcrantz, E., Hetta, J., Boman, G. (1997) Long-term follow up of patients with obstructive sleep apnea syndrome (OSAS) treated with uvulopalatopharyngoplasty (UPPP). Archives of Otolaryngology – Head and Neck Surgery 123: 157162.CrossRefGoogle Scholar
Janson, C., Hillerdal, G., Larsson, L., Hultcrantz, E., Lindholm, C.-E., Bengston, H., Hetta, J. (1994) Excessive daytime sleepiness and fatigue in non-apnoeic snorers: improvement after UPPP. European Respiratory Journal 94(7): 845849.CrossRefGoogle Scholar
Kamami, Y.-V., Pandraud, L., Bourga, A. (1997) Outpatient treatment of snoring with CO2 laser in 1198 patients. Abstr at XVI World Congress of Otorhinolaryngology and Head and Neck Surgery. Sidney 1997, p. 270.Google Scholar
Larsson, H., Carlsson-Nordlander, B., Svanborg, E. (1994) Four-year follow-up after UPPP in 50 unselected patients with obstructive sleep apnea syndrome. Laryngoscope 104: 13621368.CrossRefGoogle ScholarPubMed
Leech, J. A., Önal, E., Lopata, M. (1992) Nasal CPAP continues to improve sleep-disordered breathing and daytime oxygenation over long-term follow up of occlusive sleep apnea syndrome. Chest 102: 16511655.CrossRefGoogle ScholarPubMed
Lindberg, E. (1998) Snoring and sleep apnea – A study of evolution and consequences in a male population. Thesis, Uppsala University, Uppsala.CrossRefGoogle Scholar
Lindholm, C.-E., Hultcrantz, E., Hillerdal, G. (1990) Uvulopalatoplasty with the CO2 laser. Archives of Otorhinolaryngology – Head and Neck Surgery pp 31213125.Google Scholar
Schwartz, A. R., Gold, A. R., Schubert, N., Stryzak, A., Wise, R. A., Permutt, S., Smith, P. L. (1991) Effect of weight loss on upper airway collapsibility in obstructive sleep apnea. American Review of Respiratory Diseases 144: 494498.CrossRefGoogle ScholarPubMed