Changes in quality of life and respiratory disturbance after extended uvulopalatal flap surgery in patients with obstructive sleep apnea

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Title:	Changes in quality of life and respiratory disturbance after extended uvulopalatal flap surgery in patients with obstructive sleep apnea
Authors:	Li, HY;Chen, NH;Shu, YH;Wang, PC
Contributors:	公共衛生學院公衛系 Chang Gung Mem Hosp, Dept Otolaryngol, Sleep Ctr, Taipei 10591, Taiwan;Chang Gung Mem Hosp, Dept Pulm & Crit Care Med, Sleep Ctr, Taipei 10591, Taiwan;Natl Taiwan Univ, Coll Publ Hlth, Grad Inst Epidemiol, Taipei 10764, Taiwan;Cathay Gen Hosp, Dept Otolaryngol, Taipei 106, Taiwan;China Med Univ, Dept Publ Hlth, Taichung, Taiwan
Date:	2004
Issue Date:	2010-09-20 13:46:51 (UTC+8)
Publisher:	AMER MEDICAL ASSOC
Abstract:	objective: To evaluate the subjective and objective outcomes of extended uvulopalatal flap (EUPF) surgery in patients with obstructive sleep apnea. Design: Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Snore Outcomes Survey (SOS), Ep-worth Sleepiness Scale (ESS), and polysomnography were performed preoperatively and then 6 months postoperatively. Setting: Tertiary care, sleep disorders referral center Patients: Fifty-five consecutive patients (52 men and 3 women; mean age, 45 years) with obstructive sleep apnea. Intervention: EUPF surgery. Main outcome Measures: Overnight polysomnography variables included respiratory distress index (RDI), snore index, minimum oxygen saturation, sleep stages 1 and 2, sleep stages 3 and 4, rapid eye movement, and sleep efficiency. Questionnaire variables included SF-36, SOS, and ESS scores. Success of the operation was defined as a more than 50% reduction of the RDI from the initial value and a postoperative RDI of less than 20. Results: The overall success rate of the EUPF surgery was 82%; the RDI, snore index, and minimum oxygen saturation improved significantly after surgery (P<.001). Sleep architecture in overnight polysomnography remained unchanged (P=.48 and P=.74). Patients demonstrated significant improvement in both their SOS and ESS scores (P<.001) and significant increases in 7 of 8 SF-36 subscales (P<.05 for all). However, there was poor correlation between the improvement in quality of life and the reduction in sleep-related respiratory events. Conclusions: Extended uvulopalatal flap surgery can greatly reduce sleep-related adverse events,and proves to be an effective therapy to enhance the quality of life of patients with obstructive sleep apnea. This study also suggests that subjective and objective outcomes are equally important when reporting the results of EUPF surgery.
Relation:	ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY 130(2):195-200
Appears in Collections:	[Department of Public Health] Proceedings

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