Article Abstract

Modified uvulopalatopharyngoplasty and coblation tongue channelling in the management of obstructive sleep apnoea: a single surgeon’s experience

Authors: Leba Michael Sarkis, Donald Lee, Ron Grunstein, Nicholas W. Stow

Abstract

Background: Uvulopalatopharyngoplasty is one of the most common surgical procedures used to treat obstructive sleep apnoea (OSA). The purpose of this study was to compare pre- and post-operative apnoea hypopnoea indices (AHI), oxygen desaturation indices (ODI) and clinical symptoms using the Epworth Sleepiness scale (ESS) in patients with sleep study-confirmed OSA, who had failed or declined device therapy and who underwent the Australian modified uvulopalatopharyngoplasty (modUPPP) and Coblation tongue channelling.
Methods: This is a retrospective cohort study of 34 patients who underwent the Australian modified uvulopalatopharyngoplasty and Coblation tongue channelling performed by a single surgeon between 2012 and 2018. Pre and post-operative AHI and ODI were formally measured by polysomnogram and ESS completed. A Wilcoxon signed rank test was used to compare pre and post-operative values.
Results: A total of 34 patients underwent surgery. The median preoperative AHI was 46.4 (IQR, 17–70.5) and the median post-operative was 11.1 (IQR, 5.4–22.4). The median difference in AHI, ODI and ESS was 29, 15.6 and 1 respectively, which was statistically significant (P<0.05) across all three variables. Nineteen of the 34 patients met the conventional definition of surgical success, with Friedman 1 patients achieving 75% success.
Conclusions: The Australian modUPPP and Coblation tongue channelling was a successful treatment option for the majority of this cohort of appropriately-selected OSA patients. This cohort had more severe OSA than previously published studies with the same surgical technique, but achieved similar success rates, suggesting that severity of OSA should not necessarily be a limiting factor in selecting patients for surgery.