0583 COMPARING UPPER AIRWAY STIMULATION TO UVULOPALATOPHARYNGOPLASTY; A SINGLE UNIVERSITY EXPERIENCE.

Abstract

Introduction: Uvulopalatopharyngoplasty (UPPP) is a surgical option for patients with obstructive sleep apnea (OSA) unable to tolerate CPAP. A new alternative for select patients with OSA is upper airway stimulation (UAS). We compare outcomes of a cohort of patients undergoing UAS to UPPP. Methods: We collected data on patients undergoing UAS and expansion sphincteroplasty (ES), a variation of UPPP. We included demographic and pre and postoperative polysomnography data in the analysis. We then compared the UAS and ES cohorts. We calculated the proportion of patients reaching a postoperative AHI less than 15, 10, and 5. We defined surgical success as a postoperative AHI less than 20 with a 50% decline from baseline. Results: The ES cohort consisted of 33 patients, including 28 males and 5 females. Demographics and preoperative mean data were: age 43.48, BMI 29.6, ESS 10.69, AHI 36.47, O2 nadir 82.63, with standard deviations of 11.74, 4.49, 4.42, 20.01 and 5.37 respectively. Postoperative mean data were: AHI 13.47, O2 nadir 84.84, ESS 7, BMI 29.92, with standard deviations of 18.74, 5.48, 5.81, and 4.59 respectively. There was a 63.64% success rate with 75.76%, 54.55% and 36.36% of patients reaching a postoperative AHI less than 15, 10, and 5 respectively. The UAS cohort consisted of 54 patients, including 35 males and 19 females. Demographics and preoperative data were: age 61.46, BMI 29.41, ESS 10.55, AHI 34.65, O2 nadir 81.47, with standard deviations of 11.26, 3.59, 4.09, 20.38, and 6.81 respectively. The mean postoperative data were: AHI 6.44, O2 nadir 88.19, ESS 5.54, BMI 29.29, with standard deviations of 10.92, 3.41, 3.26, and 3.72 respectively. There was a 90.74% success rate with 92.59%, 81.48% and 70.37% of patients reaching a postoperative AHI less than 15, 10, and 5 respectively. We found a significant difference in age, preoperative AHI, postoperative AHI, postoperative O2 nadir, surgical success, and patients reaching an AHI less than 10 and 5. Conclusion: UAS is a new surgical option for select patients with OSA showing comparable or more favorable outcomes than a cohort of patients undergoing UPPP.