Surgery in the management of obstructive sleep apnea and hypopnea syndrome and snoring: Review of 71 clinical cases

Abstract

Introduction: The obstructive sleep apnea syndrome (OSA) is a highly prevalent disease and is associated with significant cardiovascular morbidity. Its etiology is multifactorial. Among the therapeutic options, surgery of the upper airway is an effective alternative in selected cases. Aim: To describe the experience of the Otorhinolaryngology Service of Hospital of the University of Chile in surgery of patients with OSA. Material and method: Retrospective descriptive study. We analyzed clinical and morbid records, demographic background, polysomnography (PSG), type of surgery, pre and post surgical Epworth scores, hospital stay, complications and follow-up. Results: Of a total of 71 patients (87% male, average age of 44 years), 88% had a preoperative diagnosis of overweight or obesity. 67% of patients were done a PSG, 64% of them showed a moderate to severe OSA. 97% of patients underwent radiofrequency uvulopalatoplasty (UPP), 62% septoplasty (SP) and 50% tonsillectomy. In 98% of patients, 2 to 4 associated techniques were used, highlighting the association of UPP plus SP as the most frequent combination (15.45%). The average hospital stay was 1.09 days. Only 7% of patients had complications. The average follow-up time was 3.05 months. Discussion: The role of surgery is to remove the collapse of the upper airway, which is achieved in most patients using associated techniques. Conclusion: Surgery for OSA should include different techniques combination, anatomical location of obstruction and patient’s profile.