Surgical Criteria for Obstructive Sleep Apnea Syndrome Based on Localization of Upper Airway Collapse during Sleep: A Preliminary Study

Abstract

Obstructive sleep apnea syndrome (OSAS) is defined as intermittent complete or partial upper airway obstruction during sleep, causing mental and physical effects. Localization of obstructions in the upper airways in OSAS patients provides indispensable information for the selection of surgical procedures. We measured the pressure within the upper airways during sleep in 6 patients with OSAS in order to select the surgical procedure. Five patients were found to have the airway collapse in the velopharynx, and in three of them underwent uvulopalatopharyngoplasty (UPPP) with tonsillectomy was performed. The remaining one patient, having an obstruction in both the velopharynx and hypopharynx, underwent laser-assisted midline glossectomy as well as UPPP. The 4 patients receiving the operation showed improvements in the sleep apnea index and the lowest oxygen saturation postoperatively. These findings suggest that pressure measurement may be a reliable tool for localizing obstructions in OSAS patients and may be used for determined the surgical option. © 1998 Tohoku University Medical Press.