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The Role of the Palatal Surgery in OSAS Treatment

Year 2005, Volume: 10 Issue: 4, 147 - 150, 01.08.2005

Abstract

The uvulopalatopharyngoplasty (UPPP) first described in 1981 by Fujita et al [], continues to be the mainstay for surgical treatment of OSA patient. . Since its introduction, there has been considerable effort expended studying the efficacy of this procedure and the role that it should play in the management of OSA. Unfortunately, the results of these studies have shown that UPPP as an isolated intervention for the treatment of OSA has met with mediocre results. Isolated UPPP has been shown to have limited success for treatment of OSA patients. In comparison, palatal procedures combined with other surgical approaches that address the multiple sites of obstruction in the upper aerodigestive tract seem to have improved success in the carefully selected patient. ©2005, Fırat Üniversitesi, Tıp Fakültesi

References

  • Fujita S, Conway W, Zorick F, Roth T. Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg. 1981; 89: 923-934.
  • Asher Qureshi, Robert D. Ballard. Obstructive sleep apnea. J Allergy Clin Immunol 2003; 112: 643-651.
  • Sher AE. Upper airway surgery for obstructive sleep apnea. Sleep Med Rev. 2002; 6: 195-212.
  • Riley RW, Powell NB, Guilleminault C: Obstructive sleep apnea syndrome: A review of 306 consecutively treated surgical patients. Otolaryngology Head and Neck Surg 1993; 108: 117.
  • Riley RW, Powell NB, Guilleminault C: Inferior mandıbular osteotomy and hyoid myotomy suspension for obstructive sleep apnea: A review of 55 patients. J Oral Maxillomaxfac Surg 1989; 47: 159.
  • Ikematsu T. Study of snoring, 4th report: therapy. Journal of Japanese Otorhinolaryngology 1964; 64: 434-435.
  • Çelik O. Kulak Burun Boğaz Hastalıkları ve Baş ve Boyun Cerrahisi. 1. Baskı, İstanbul: Turgut Yayıncılık, 2002: 964-984.
  • Katsantonis GP, Friedman WH, Krebs FJ 3rd, Walsh JK. Nasopharyngeal complications following uvulopalatopharyngoplasty. Larnygoscope 1987; 97:309-314.
  • Fairbanks DNF: Uvulopalatopharyngoplasty complications and avoidance strategies. Otolarngol Head Neck Surg 1990; 102: 239- 245.
  • Powell N, Riley R, Guilleminault C, Troell R. A reversible uvulopalatal flap for snoring and sleep apnea syndrome. Sleep. 1996 Sep; 19: 593-599.
  • Sher AE, Schechtman KB, Piccirillo JF. The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep. 1996; 19: 156-177.
  • Krespi YP,Pearlman SJ,Keidar A. Laser-assisted uvulopalatoplasty for snoring.J.Otolaryngol 1994; 23: 328-334.
  • Hudgel DW, Harasick T, Katz RL, Witt WJ, Abelson TI. Uvulopalatopharyngoplasty in obstructive apnea: value of preoperative localization of site of upper airway narrowing during sleep. Am Rev Respir Dis 1991; 143: 942-946.
  • Larsson H, Carlsson-Nordlander B, Svanborg E. Four year follow-up after uvulopalatopharnygoplasty in 50 unslected patients with obstructive sleep apnea syndrome. Laryngoscope 1994; 104: 1362-1368.
  • Larsson H, Carlsson-Nordlander B, Svanborg E. Long-time follow-up after UPPP for obstructive sleep apnea syndrome. Acta Otolaryngol (Stock) 1991; 111: 582-590 .
  • Riley R, Guilleminault C, Powell N, Simmons FB. Palatopharyngoplasty failure, cephalometric roentgenograms, and obstructive sleep apnea. Otolaryngol Head and Neck Surg 93: 240, 1985.
  • Rivlin J, Hoffstein V, Kalbfleisch J, McNicholas W, Zamel N, Bryan AC. Upper airway morphology in patients with idiopathic obstructive sleep apnea. Am Rev Respir Dis 129: 355, 1984.
  • Rojewski TE, Schuller DE, Clark RW: Video endoskopic determinations of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 1996; 19: 156.
  • Rojewski TE, Schuller DE, Clark RW, Schmidt HS, Potts RE. Videoendoscopic determination of the mechanism of obstruction in obstructive sleep apnea. Otolaryngol Head Neck Surg. 1984; 92: 127-131.
  • Hudgel DW, Harasick T, Katz RL, Witt WJ, Abelson TI. Uvulopalatopharyngoplasty in obstructive apnea. Value of preoperative localization of site of upper airway narrowing during sleep. Am Rev Respir Dis. 1991; 143: 942-946.
  • Larsson LH, Carlsson-Nordlander B, Svanborg E. Four-year follow-up after uvulopalatopharyngoplasty in 50 unselected patients with obstructive sleep apnea syndrome. Laryngoscope. 1994; 104: 1362-1368.
  • Riley RW, Powell NB, Guilleminault C. Obstructive sleep apnea and the hyoid: a revised surgical procedure. Otolaryngol Head Neck Surg. 1994; 111: 717-721.
  • Hishikawa Y, Furuya E, Wakamatsu H, Yamamoto J. A polygraphic study of hypersomnia with periodic breathing and primary alveolar hypoventilation. Bull Physiopathol Respir (Nancy). 1972; 8: 1139-1151.
  • Simmons FB, Guilleminault C, Dement WC, Tilkian AG, Hill M. Surgical management of airway obstructions during sleep. Laryngoscope. 1977; 87: 326-338.
  • Riley RW, Powell NB, Guilleminault C, Pelayo R, Troell RJ, Li KK. Obstructive sleep apnea surgery: risk management and complications. Otolaryngol Head Neck Surg. 1997; 117: 648-652.
  • Burgess LP, Derderian SS, Morin GV, Gonzalez C, Zajtchuk JT. Postoperative risk following uvulopalatopharyngoplasty for obstructive sleep apnea. Otolaryngol Head Neck Surg. 1992; 106: 81-86.
  • Kabul Tarihi: 28.10.2005

OSAS Tedavisinde Palatal Cerrahinin Yeri

Year 2005, Volume: 10 Issue: 4, 147 - 150, 01.08.2005

Abstract

Uvulopalatofarengoplasti (UPPP) ilk olarak 1981 yılında Fujita ve arkadaşları[] tarafından tanımlanmış ve obstrüktif sleep apne sendromu (OSAS) cerrahi tedavisinde başlıca temel teknik olarak kabul edilmiştir. Bu tekniğin ilk tanımlanmasından itibaren yöntemin sleep apne tedavisindeki etkinliği araştırılmıştır. Maalesef bu çalışmaların sonucunda tek başına UPPP' nin tedavideki etkinliğinin sınırlı olduğu görülmüştür. Tek başına UPPP, sleep apneli hastaların tedavisinde sınırlı başarı oranına sahiptir. Buna karşılık, özenle seçilmiş hastalarda, palatal prosedürler üst hava yolundaki obstrüksiyon yerlerine yönelik diğer cerrahi yöntemlerle kombine edildiğinde başarı oranı artmaktadır. ©2005, Fırat Üniversitesi, Tıp Fakültesi

References

  • Fujita S, Conway W, Zorick F, Roth T. Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg. 1981; 89: 923-934.
  • Asher Qureshi, Robert D. Ballard. Obstructive sleep apnea. J Allergy Clin Immunol 2003; 112: 643-651.
  • Sher AE. Upper airway surgery for obstructive sleep apnea. Sleep Med Rev. 2002; 6: 195-212.
  • Riley RW, Powell NB, Guilleminault C: Obstructive sleep apnea syndrome: A review of 306 consecutively treated surgical patients. Otolaryngology Head and Neck Surg 1993; 108: 117.
  • Riley RW, Powell NB, Guilleminault C: Inferior mandıbular osteotomy and hyoid myotomy suspension for obstructive sleep apnea: A review of 55 patients. J Oral Maxillomaxfac Surg 1989; 47: 159.
  • Ikematsu T. Study of snoring, 4th report: therapy. Journal of Japanese Otorhinolaryngology 1964; 64: 434-435.
  • Çelik O. Kulak Burun Boğaz Hastalıkları ve Baş ve Boyun Cerrahisi. 1. Baskı, İstanbul: Turgut Yayıncılık, 2002: 964-984.
  • Katsantonis GP, Friedman WH, Krebs FJ 3rd, Walsh JK. Nasopharyngeal complications following uvulopalatopharyngoplasty. Larnygoscope 1987; 97:309-314.
  • Fairbanks DNF: Uvulopalatopharyngoplasty complications and avoidance strategies. Otolarngol Head Neck Surg 1990; 102: 239- 245.
  • Powell N, Riley R, Guilleminault C, Troell R. A reversible uvulopalatal flap for snoring and sleep apnea syndrome. Sleep. 1996 Sep; 19: 593-599.
  • Sher AE, Schechtman KB, Piccirillo JF. The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep. 1996; 19: 156-177.
  • Krespi YP,Pearlman SJ,Keidar A. Laser-assisted uvulopalatoplasty for snoring.J.Otolaryngol 1994; 23: 328-334.
  • Hudgel DW, Harasick T, Katz RL, Witt WJ, Abelson TI. Uvulopalatopharyngoplasty in obstructive apnea: value of preoperative localization of site of upper airway narrowing during sleep. Am Rev Respir Dis 1991; 143: 942-946.
  • Larsson H, Carlsson-Nordlander B, Svanborg E. Four year follow-up after uvulopalatopharnygoplasty in 50 unslected patients with obstructive sleep apnea syndrome. Laryngoscope 1994; 104: 1362-1368.
  • Larsson H, Carlsson-Nordlander B, Svanborg E. Long-time follow-up after UPPP for obstructive sleep apnea syndrome. Acta Otolaryngol (Stock) 1991; 111: 582-590 .
  • Riley R, Guilleminault C, Powell N, Simmons FB. Palatopharyngoplasty failure, cephalometric roentgenograms, and obstructive sleep apnea. Otolaryngol Head and Neck Surg 93: 240, 1985.
  • Rivlin J, Hoffstein V, Kalbfleisch J, McNicholas W, Zamel N, Bryan AC. Upper airway morphology in patients with idiopathic obstructive sleep apnea. Am Rev Respir Dis 129: 355, 1984.
  • Rojewski TE, Schuller DE, Clark RW: Video endoskopic determinations of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 1996; 19: 156.
  • Rojewski TE, Schuller DE, Clark RW, Schmidt HS, Potts RE. Videoendoscopic determination of the mechanism of obstruction in obstructive sleep apnea. Otolaryngol Head Neck Surg. 1984; 92: 127-131.
  • Hudgel DW, Harasick T, Katz RL, Witt WJ, Abelson TI. Uvulopalatopharyngoplasty in obstructive apnea. Value of preoperative localization of site of upper airway narrowing during sleep. Am Rev Respir Dis. 1991; 143: 942-946.
  • Larsson LH, Carlsson-Nordlander B, Svanborg E. Four-year follow-up after uvulopalatopharyngoplasty in 50 unselected patients with obstructive sleep apnea syndrome. Laryngoscope. 1994; 104: 1362-1368.
  • Riley RW, Powell NB, Guilleminault C. Obstructive sleep apnea and the hyoid: a revised surgical procedure. Otolaryngol Head Neck Surg. 1994; 111: 717-721.
  • Hishikawa Y, Furuya E, Wakamatsu H, Yamamoto J. A polygraphic study of hypersomnia with periodic breathing and primary alveolar hypoventilation. Bull Physiopathol Respir (Nancy). 1972; 8: 1139-1151.
  • Simmons FB, Guilleminault C, Dement WC, Tilkian AG, Hill M. Surgical management of airway obstructions during sleep. Laryngoscope. 1977; 87: 326-338.
  • Riley RW, Powell NB, Guilleminault C, Pelayo R, Troell RJ, Li KK. Obstructive sleep apnea surgery: risk management and complications. Otolaryngol Head Neck Surg. 1997; 117: 648-652.
  • Burgess LP, Derderian SS, Morin GV, Gonzalez C, Zajtchuk JT. Postoperative risk following uvulopalatopharyngoplasty for obstructive sleep apnea. Otolaryngol Head Neck Surg. 1992; 106: 81-86.
  • Kabul Tarihi: 28.10.2005
There are 27 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Murat Enöz This is me

Publication Date August 1, 2005
Published in Issue Year 2005 Volume: 10 Issue: 4

Cite

APA Enöz, M. (2005). OSAS Tedavisinde Palatal Cerrahinin Yeri. Fırat Tıp Dergisi, 10(4), 147-150.
AMA Enöz M. OSAS Tedavisinde Palatal Cerrahinin Yeri. Fırat Tıp Dergisi. August 2005;10(4):147-150.
Chicago Enöz, Murat. “OSAS Tedavisinde Palatal Cerrahinin Yeri”. Fırat Tıp Dergisi 10, no. 4 (August 2005): 147-50.
EndNote Enöz M (August 1, 2005) OSAS Tedavisinde Palatal Cerrahinin Yeri. Fırat Tıp Dergisi 10 4 147–150.
IEEE M. Enöz, “OSAS Tedavisinde Palatal Cerrahinin Yeri”, Fırat Tıp Dergisi, vol. 10, no. 4, pp. 147–150, 2005.
ISNAD Enöz, Murat. “OSAS Tedavisinde Palatal Cerrahinin Yeri”. Fırat Tıp Dergisi 10/4 (August 2005), 147-150.
JAMA Enöz M. OSAS Tedavisinde Palatal Cerrahinin Yeri. Fırat Tıp Dergisi. 2005;10:147–150.
MLA Enöz, Murat. “OSAS Tedavisinde Palatal Cerrahinin Yeri”. Fırat Tıp Dergisi, vol. 10, no. 4, 2005, pp. 147-50.
Vancouver Enöz M. OSAS Tedavisinde Palatal Cerrahinin Yeri. Fırat Tıp Dergisi. 2005;10(4):147-50.