The indications for pharyngeal surgery in adult with sleep-disordered breathing patients

Abstract

We assessed the indications for pharyngeal surgery, including tonsillectomy and uvulopalatopharyngoplasty (UPPP) for patients with sleep-disordered breathing (SDB). The indications for surgery can be divided into two groups. In the first group, the indicated surgery is a radical treatment of SDB. The characteristics of this group were 1) grade 1 tonsillar hypertrophy, 2) bilateral (side to side type) oropharyngeal stenosis, as determined using a snoring sound test, and 3) no risk of facial disfiguration. In this group, the improvement in AHI (Apnea Hypopnea Index) was 76.2%, while the improvement in AI (Apnea Index) was 95.7%. In the second group, the treatment was designated as supplemental. The characteristics of this group were 1) bilateral oropharyngeal stenosis, 2) tonsillar hypertrophy larger than grade 2, and 3) unsuccessful treatment with NCPAP (Nasal Continuous Positive Airway Pressure) or oral appliances. In this group, the improvement in AHI was 50.7%, but, surgery remained an effective means of treating SDB.