Scientific Investigations
Modified Uvulopalatopharyngoplasty and Coblation Channeling of the Tongue for Obstructive Sleep Apnea: A Multi-Centre Australian Trial
http://dx.doi.org/10.5664/jcsm.2402
Stuart G. MacKay, M.D.1,2; A. Simon Carney, M.D.3,4; Charmaine Woods, Ph.D.3,4; Nick Antic, Ph.D.4,5; R. Doug McEvoy, M.D.4,5; Michael Chia, M.D.6; Terry Sands, M.D.7; Andrew Jones, M.D.8; Jonathan Hobson, M.D.4; Samuel Robinson, M.D.3,4,9
1Division of Otolaryngology, Head and Neck Surgery, University of Wollongong, Wollongong, NSW, Australia; 2Illawarra ENT Head and Neck Clinic, Wollongong, NSW, Australia; 3Department of Otolaryngology, Head and Neck Surgery, Flinders Medical Centre, Adelaide, South Australia; 4Flinders University, South Australia; 5Adelaide Institute for Sleep Health, Daw Park, South Australia; 6Memorial Hospital Sleep Disorders Service, Adelaide, South Australia; 7Division of Paediatrics and Sleep Medicine, University of Wollongong, Wollongong, NSW, Australia; 8Division of Respiratory and Sleep Medicine, University of Wollongong, Wollongong, NSW, Australia; 9Memorial Hospital, Adelaide, South Australia
Study Objectives:
To investigate the surgical outcomes and efficacy of modified uvulopalatopharyngoplasty (mod UPPP) and Coblation channelling of the tongue (CCT) as a treatment for obstructive sleep apnea (OSA).
Methods:
Adult patients with simple snoring or obstructive sleep apnea were treated with combined modified UPPP, bilateral tonsillectomy, and CCT (N = 48). Full polysomnography was performed preoperatively and 3 months postoperatively. Postoperative clinical assessment, sleep questionnaires, and patient demographics including body mass index were compared to preoperative data. All polysomnograms were re-scored to AASM recommended criteria by 2 sleep professionals.
Results:
The preoperative AHI (median and interquartile range) of 23.1 (10.4 to 36.6) was lowered to a postoperative AHI of 5.6 (1.9 to 10.4) (p < 0.05). The Epworth Sleepiness Scale score fell from 10.5 (5.5 to 13.5) to 5.0 (3.09 to 9.5) (p < 0.05). Morbidity of the surgery was low, with no long-term complications recorded.
Conclusions:
Modified UPPP combined with CCT is a highly efficacious intervention for OSA with minimal morbidity. It should be considered for individuals who fail or are intolerant of CPAP or other medical devices.
Citation:
MacKay SG; Carney AS; Woods C; Antic N; McEvoy RD; Chia M; Sands T; Jones A; Hobson J; Robinson S. Modified uvulopalatopharyngoplasty and coblation channeling of the tongue for obstructive sleep apnea: a multi-centre australian trial. J Clin Sleep Med 2013;9(2):117–124.
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