Currently, uvulopalatopharyngoplasty (UPPP) is the most common surgical procedure
used for the treatment of obstructive sleep apnea. Patients with clinically significant
obstructive sleep apnea in whom medical treatment has failed or who are unwilling
to comply with medical therapy are considered candidates for UPPP. The initial surgical
results obtained in nonselected patients with obstructive sleep apnea were highly
variable, approximately half of the patients experiencing more than a 50% reduction
in the frequency of disordered breathing events postoperatively. Although differences
in surgical technique likely account for some of the variability, preoperative differences
in the site (or sites) of upper airway collapse are also thought to influence the
surgical results. Because UPPP involves resection of the uvula, distal margin of the
soft palate, palatine tonsils, and any excessive lateral pharyngeal tissue, patients
with anatomic narrowing and collapse confined to the velopharyngeal or retropalatal
region of the upper airway are considered optimal surgical candidates. Fiberoptic
pharyngoscopy, cephalometric roentgenography, computed tomography, and somnofluoroscopy
are procedures that can be used preoperatively to help select optimal candidates for
UPPP. The results suggest that the success rate of UPPP can approach 66% with careful
preoperative selection of patients.
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Article Info
Footnotes
Individual reprints of this article are not available. The entire Symposium on Sleep Disorders will be available for purchase as a bound booklet from the Proceedings Circulation Office in October.
Identification
Copyright
© 1990 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
