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International Bulletin of Otorhinolaryngology

Our experience in the surgical treatment of Obstructive Sleep Apnea

A. Valkov, Tsv. Mladenov, B. Duhlenski, Tsv. Stoyanov, G. Nikolov, M. Yildiz, Kr. Atanasova, St. Mirchev

Abstract

Background: Obstructive Sleep Apnea (OSA) is a sleep-related breathing disorder, leading to decreased quality of life, increased risk of cardiovascular morbidity and mortality, increased frequency of automobile accidents. Continuous positive airway pressure (CPAP) remains the first line of treatment for OSA. Many patients are unwilling or incapable to tolerate the treatment and therefore turn to surgical options to alleviate symptoms and sequela of the disease.
Аim: To present our experience in the surgical treatment of OSA.
Materials and Methods: 50 patients (48 male / 2 female) underwent surgical treatment for OSA in our clinic for a period of 10 years. Subjective complaints were evaluated by interview of the patient and partner pre- and postoperatively, with key factors studied being snoring level (visual analogue 1–10) and Epworth Sleepiness Scale (ESS). Objective data were Body Mass Index (BMI), nasal endoscopy, pre and postoperative polysomnographic data, rhinomanometry, Mallampati score, diagnostic imaging of the nose and sinuses.
Results: The mean BMI of the patients was 29.8± 3.4. 21 patients had nasal obstruction for which they underwent surgical treatment. 5 patients had micro or retrognathia. 37 Pateints had a Mallampati score of 3 and 13 of 4. All 50 patients underwent Uvulopalatopharyngoplasty (UPPP) and 6 patients also had Radiofrequency tongue base reduction. There were no serious complications. Subjective improvement in the severity of the symptoms was obtained in 88% (44) of patients. Objective success was obtained in 56% (28) of the patients.
Conclusions: Surgical treatment of OSA leads to a significant subjective improvement in the severity of symptoms and acceptable objective results. For maximal results a multidisciplinary approach is required for the complex treatment of OSA.

Keywords

UPPP, OSA, surgical treatment

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DOI: http://dx.doi.org/10.14748/orl.v17i1.7746

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