Long-term results of one staged multilevel surgery with tongue suspension surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea

• Published in: European archives of oto-rhino-laryngology Vol. 273; no. 5; pp. 1227 - 1234
• Main Authors: Yüksel, Alper, Ugur, Kadriye Serife, Kizilbulut, Gultekin, Ark, Nebil, Kurtaran, Hanifi, Kaya, Mesut, Gunduz, Mehmet
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2016
• Subjects: Adult; Cross-Sectional Studies; Female; Head and Neck Surgery; Hospitals, University; Humans; Laryngology; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Oral Surgical Procedures - adverse effects; Oral Surgical Procedures - methods; Otorhinolaryngology; Pain Measurement - methods; Palate - surgery; Polysomnography - methods; Postoperative Period; Prospective Studies; Severity of Illness Index; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - physiopathology; Sleep Apnea, Obstructive - surgery; Snoring - diagnosis; Snoring - surgery; Time; Tongue - surgery; Treatment Outcome; Turkey; Tongue base suspension; Apnea–hypopnea index; Obstructive sleep apnea (OSA); Snoring
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-015-3813-4

The objective of this study is to evaluate and compare the long-term efficacy of the one staged multilevel surgery (MLS) with tongue suspension (TBS) surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea (OSA). This is a prospective cross-sectional study. Setting: University hospital. Thirty-three patients diagnosed as moderate to severe OSA. Patients, with ≥50 % retropalopharyngeal obstruction on the Müller maneuver, were treated with palatal surgeries (PS) and patients, with ≥50 % retropalopharyngeal obstruction on the Müller maneuver with ≥50 % base of the tongue collapse, were treated with palatal surgeries and tongue suspension surgery (TBS). Patients were evaluated with one night polysomnography before the surgery and 24 months after the surgery. Patients completed Epworth sleepiness scale (ESS), snoring VAS (visual analog scale) before and 24 months after the surgery. Nine-teen patients with a mean age of 46.1 ± 8.3 underwent palatal surgeries (PS) and 14 patients with a mean age of 41.4 ± 8.9 underwent PS plus TBS. Success rate in TBS+PS group was 57.1 % and in PS group was 42.1 %. In both groups total apnea–hypopnea index (AHI) values significantly decreased after 2 years ( p  < 0.025) but there was no statistically significant difference between TBS+PS and PS groups. Supine AHI levels were reduced statistically significant in both groups postoperatively ( p  < 0.025). There was not any significant difference postoperatively in non-supine AHI levels in both groups ( p  > 0.025). There were significant postoperative changes in ODI, AVO2, MOS, ESS, Snoring VAS values in PS group ( p  < 0.025). In TBS+PS group there was a significant difference postoperatively only in ODI values. Treatment of OSA patients with retropalatal or retropalatal and retroglossal obstruction, in a one staged surgery, is a safe and easy procedure. We have achieved favorable long-term outcomes in moderate–severe OSA patients undergoing both palatal surgery and tongue suspension surgery.