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March 1997

Long-term Follow-up of Patients With Obstructive Sleep Apnea Treated With Uvulopalatopharyngoplasty

Author Affiliations

From the Departments of Lung Medicine (Drs Janson, Lindberg, and Boman), Psychiatry (Sleep Unit) (Drs Bengtsson and Hetta and Mr Eriksson), and Otolaryngology (Drs Lindholm and Hultcrantz), Akademiska sjukhuset, Uppsala, Sweden; the Department of Public Health Medicine, United Medical and Dental Schools, St Thomas' Hospital, London, England (Dr Janson); and the Department of Lung Medicine, Vifilsstadir Hospital, Gardabaer, Iceland (Dr Gislason).

Arch Otolaryngol Head Neck Surg. 1997;123(3):257-262. doi:10.1001/archotol.1997.01900030025003

Objective:  To study the long-term outcome after treatment with uvulopalatopharyngoplasty (UPPP).

Design:  Long-term follow-up (4-8 years) with polysomnography.

Setting:  Referral center for patients with sleep-disordered breathing.

Patients:  Thirty-four consecutive patients of whom 25 (22 men and 3 women; mean age, 49 years) participated in the follow-up. All patients had obstructive sleep apnea syndrome.

Intervention:  Uvulopalatopharyngoplasty.

Main Outcome Measures:  Symptoms and apnea-hypopnea index (AHI) before and after UPPP. Response to treatment defined as a 50% or more reduction in AHI and a postoperative AHI of 10 or less.

Results:  Reduced prevalence of snoring and daytime sleepiness and reduction in AHI (mean [±SD], 40 ±26 to 21±21) at follow-up (P<.001). Sixteen patients (64%) were responders after 6 months and 12 (48%) at the long-term follow-up. Responders had a lower preoperative AHI (25±7) than did nonresponders (48±29) (P<.05). None of the 7 patients with preoperative AHI of more than 40 were responders (P<.01). No difference was seen in preoperative body mass index, lung function, ventilatory response to carbon dioxide, computed tomography scan of upper airways, or change in body mass index between responders and nonresponders.

Conclusions:  Four to 8 years after UPPP, about half of our patients were clinically and objectively improved. Uvulopalatopharyngoplasty should be reserved for patients with mild or moderate obstructive sleep apnea. After UPPP, long-term follow-up is recommended because some initially successfully treated patients will relapse in the long term.Arch Otolaryngol Head Neck Surg. 1997;123:257-262