The effects of lateral pharyngoplasty on carotid intima-media thickness in patients with obstructive sleep apnoea

Abstract

Introduction: Obstructive sleep apnea (OSA) is a known risk factor for development of carotid atherosclerosis. The treatment of OSA, through positive pressure devices or surgical procedures, may reduce the signs of subclinical atherosclerosis in apneic patients. Objective: The decrease of carotid intima-media thickness (CIMT) after treatment of OSA remains a highly controversial issue. Our purpose is to compare CIMT, which represents an early sign of atherosclerosis, before and at least 6 months after lateral pharyngoplasty in patients with OSA. Material and Methods: A total of 17 patients with OSA who underwent lateral pharyngoplasty were submitted to common carotid Doppler ultrasonography, 24-hour ambulatory blood pressure monitoring and type-1 polysomnography before and at least 6 months after surgery. Results: The median apnoeahypopnoea index decreased from 22.6 to 5.9 (p<0.001). There were significant improvements in the arousal index, minimum oxyhaemoglobin saturation, Epworth sleepiness scale and reported snoring intensity. The surgical success rate (Shers criteria) obtained with the procedure was 76.4%. There was no significant variation in the mean CIMT after surgeries (right carotid artery, mean, 0.67 and 0.72 mm; left carotid artery, mean, 0.69 and 0.70 mm, pre- and postoperative, respectively, both p>0.05). Blood pressure measurements also did not significantly change. Conclusion: Notwithstanding a significant improvement in OSA after lateral pharyngoplasty, there was no significant reduction in CIMT in a follow-up of 6 months.