The efficacy of genioglossus advancement and uvulopalatopharyngoplasty for obstructive sleep apnea syndrome

Abstract

Objective: To evaluate the objective and subjective improvement after multilevel surgery, genioglossus advancement (GA) plus uvulopalatopharyngoplasty (UPPP) for the treatment of obstructive sleep apnea syndrome (OSAS). Methods: GA and UPPP were undertaken in 24 patients with moderate and severe OSAS between January 2006 and December 2011. Epworth Sleepiness Scale (ESS) score, snoring, the feeling of having slept well and polysomnography were used for the evaluation of surgical outcomes. In addition, we determined whether baseline polysomnography, cephalometry, and authropometry data could predict GA and UPPP success or failure. Results: The mean ESS score decreased significantly from 12.96 to 7.08. The mean apnea-hypopnea index (AHI) improved from 37.3 to 19.33. Objective success as evaluated by a 50% reduction in AHI or by AHI<15 was obtained in 16 of 24 patients. The lowest oxygen saturation and stage 1 and stage 2 were also improved significantly. There were no major postoperative complications. There were significant differences in SNA, SNB, FX and PNS-P between the success and failure of GA and UPPP. The indication of GA and UPPP were SNA>79.11 degrees, SNB>75.69 degrees, FX> 78.67 degrees, and 36.79 mm < 42.29 mm. Conclusion: GA and UPPP surgeries are effective and safe for patients with moderate and severe OSAS. However, further studies are necessary to decide definitively if GA and UPPP are appropriate treatments for OSAS.