4-YEAR FOLLOW-UP AFTER UVULOPALATOPHARYNGOPLASTY IN 50 UNSELECTED PATIENTS WITH OBSTRUCTIVE SLEEP-APNEA-SYNDROME

Fifty unselected consecutive patients with obstructive sleep apnea syn drome (OSAS) diagnosed by nocturnal recordings of respiration movement s by a static charge sensitive bed (SCSB) and oximetry, alone or combi ned with polysomnography, were studied. Renewed SCSB-oximetry recordin gs evaluated treatment. Six months after surgery, 30 of 50 were classi fied as responders. Twenty-one months after surgery, 19 of 49 were res ponders. Patients who relapsed showed a significant increase in mean b ody mass index (BMI). Four years after surgery, 24 of 48 patients were responders. Preoperative BMI was significantly lower in the responder group. Subsequent treatment was required in 15 nonresponders. There w as no correlation between patients' subjective improvement and objecti ve results. The study resulted in the following conclusions: 1. The re sponder rate to UPPP in unselected patients is low 2. Obesity and high indices of nocturnal respiratory disturbance are negative predictors. 3. The patients' subjective recovery alone must not be used for posto perative evaluation. 4. With regular follow-up and the use of the trea tment alternatives available today, the majority of OSAS patients can receive effective treatment.