Surgery and obstructive sleep apnea: Long-term clinical outcomes
Partially funded by the Sleep Education and Research Foundation.
Presented at the Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery, San Antonio, TX, September 13-16, 1998.
Abstract
OBJECTIVE
Outcome data on the surgical treatment of obstructive sleep apnea are, in general, based on short-term follow-up (<6-9 months). This examination was undertaken to assess long-term results.
METHODS
Forty patients who underwent soft tissue and skeletal surgery were the subjects of this review. Methods of evaluation included polysomnographic variables (respiratory disturbance index [RDI], low oxyhemoglobin desaturation [LSAT]), body mass index, quality-of-life assessments, roentgenographic analysis, and complications. Statistical analysis used the SAS 6.12 system.
RESULTS
Thirty-six of 40 patients (90%) showed long-term clinical success. The mean preoperative RDI, nasal continuous positive airway pressure RDI, and long-term RDI were 71.2 ± 27.0, 7.6 ± 5.2 and 7.6 ± 5.1, respectively. The mean preoperative LSAT, nasal continuous positive airway pressure LSAT, and long-term LSAT were 67.5% ± 14.8%, 87.1% ± 3.2%, and 86.3% ± 3.9%, respectively. The mean follow-up was 50.7 ± 31.9 months. The patients showed a statistically significant long-term weight gain (P = 0.0002) compared with their 6-month postoperative level (body mass index 31.4 ± 6.7 vs 32.2 ± 6.3). There was a positive correlation with the amount of skeletal advancement and clinical outcome.
CONCLUSION
Comprehensive evaluation and surgical treatment can result in successful long-term clinical outcome.