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Erschienen in: Sleep and Breathing 4/2018

16.05.2018 | Sleep Breathing Physiology and Disorders • Original Article

Complete concentric collapse at the soft palate in sleep endoscopy: what change is possible after UPPP in patients with CPAP failure?

verfasst von: Katrin Hasselbacher, A. Seitz, N. Abrams, B. Wollenberg, A. Steffen

Erschienen in: Sleep and Breathing | Ausgabe 4/2018

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Abstract

Purpose

The aim of this work was to assess whether uvulopalatopharyngoplasty in patients with failure for positive airway pressure not only reduces the degree of obstructive sleep apnea but also to determine as well if it changes the collapse pattern of the soft palate and thereby fulfills the qualifications for implementing upper airway stimulation (UAS) as an adjunctive solution.

Method

Fifteen patients with intolerance for positive airway pressure were included in this retrospective cohort study. Polygraphy and drug-induced sleep endoscopy were used in order to evaluate the reduction of the apnea-hypopnea index (AHI), as well as the change of collapse pattern at the soft palate level before and about 3 months after uvulopalatopharyngoplasty and tonsillectomy (TE-UPPP).

Results

In 93% of the patients, a postoperative change of the initially complete concentric palatal collapse pattern could be found during drug-induced sleep endoscopy. In one patient, no obstruction at all was seen at the soft palatal level. Only one patient still presented with a complete concentric collapse at velum level. AHI decreased from mean 34.7 events per hour to 20.2/h and oxygen desaturation index from 25.3 events per hour to 16.1/h.

Conclusion

Patients seeking for positive airway pressure alternatives could not only benefit from reduction of AHI by TE-UPPP postoperatively; additionally, by changing the collapse pattern at the soft palate, they might also fulfill criteria for upper airway stimulation (UAS) in case of persistent OSA of at least moderate degree.
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Metadaten
Titel
Complete concentric collapse at the soft palate in sleep endoscopy: what change is possible after UPPP in patients with CPAP failure?
verfasst von
Katrin Hasselbacher
A. Seitz
N. Abrams
B. Wollenberg
A. Steffen
Publikationsdatum
16.05.2018
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 4/2018
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-018-1657-z

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