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European Archives of Oto-Rhino-Laryngology
Erschienen in: European Archives of Oto-Rhino-Laryngology 7/2018

25.05.2018 | Review Article

Palate surgery for obstructive sleep apnea: a 17-year meta-analysis

verfasst von: Kenny Peter Pang, Guillermo Plaza, Peter M. Baptista J, Carlos O’Connor Reina, Yiong Huak Chan, Kathleen A. Pang, Edward B. Pang, Cybil Mei Zhi Wang, Brian Rotenberg

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 7/2018

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Abstract

Objectives

Systematic review of palate surgery for the treatment of OSA.

Methods

Independent searches to identify publications relevant to OSA treatment and upper airway palate surgery. All relevant studies published between January 2001 and February 2018 were included. Inclusion criteria were adult patients, documented airway evaluation methods and absent hypopharyngeal collapse. Outcomes included success rates of treatment, AHI, Epworth scale, QOL and snoring VAS.

Results

Fifty-nine papers with a total of 2715 patients, UPPP accounted for 16.7% of all the procedures. Evident differentiation progressing from 2001 to 2018, from 2001 to 2010, the percentage of UPPP procedures were 25.67%, from 2011 to 2018, there were only 12.6% of UPPP procedures. The average follow up was 8.18 months. Meta-analysis on the AHI change for all procedures, showed the fixed effect AHI per follow-up (FU) month change was 1.45 (95% CI 1.33, 1.8), p < 0.001; while for ESS, the fixed effect AHI per FU month change was 0.61 (95% CI 0.56, 0.66), p < 0.001. The mean decrease in AHI was from 35.66 to 13.91 (p < 0.001). The mean decrease in ESS was from 11.65 to 5.08 (p < 0.001). The mean AHI change was 19.9 (p < 0.001). The mean ESS change was 5.8 (p < 0.001). The overall pooled success rate was 67.5%. Meta-analysis of the procedures, showed that the respective mean AHI reduction was 24.7 for the anterior palatoplasty (p = 0.015), 19.8 for the lateral/expansion pharyngoplasty (p = 0.046), and 17.2 for the uvulopalatopharyngoplasty (p = 0.360).

Conclusions

Better understanding of the upper airway and objective airway evaluation diagnostic techniques and innovative palate surgeries have improved success rates of OSA surgery.
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Metadaten
Titel
Palate surgery for obstructive sleep apnea: a 17-year meta-analysis
verfasst von
Kenny Peter Pang
Guillermo Plaza
Peter M. Baptista J
Carlos O’Connor Reina
Yiong Huak Chan
Kathleen A. Pang
Edward B. Pang
Cybil Mei Zhi Wang
Brian Rotenberg
Publikationsdatum
25.05.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 7/2018
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-018-5015-3

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