Clinical Outcome of Uvulopalatopharyngoplasty in the Treatment of Patients with Obstructive Sleep Apnea

Abstract

Uvulopalatopharyngoplasty (UPPP) remains the most commonly performed surgical procedure as treatment of obstructive sleep apnea/hypopnea syndrome (OSAHS). Although curative for many patients, the procedure has an extremely high over-all failure rate, causing many questions on its validity. A meta-analysis revealed a success rate of UPPP as low as 40%. The reason for this low success rate might be due to the variable obstruction sites of the upper airway, causing OSAHS. Furthermore, the results of UPPP has been reported to decrease with time. Difficult localization of the upper airway obstruction sites accounts for the low success rate of UPPP. Proper selection of UPPP candidates based on Friedman Staging System, recently introduced, has reported an improved success rate as high as 80%. Furthermore, the concept of multilevel surgery for tongue base and nasal cavity in addition to UPPP enables better surgical outcomes. In conclusion, with its advantages of easy applicability and less invasiveness, better surgical outcome of UPPP might be anticipated with multilevel surgery including the tongue base and the nasal cavity in selected patients.