LONG-TERM FOLLOW-UP OF PATIENTS WITH OBSTRUCTIVE SLEEP-APNEA TREATED WITH UVULOPALATOPHARYNGOPLASTY

Objective: To study the long-term outcome after treatment with uvulopa latopharyngoplasty (UPPP). Design: Long-term follow-up (4-8 years) wit h polysomnography. Setting: Referral center for patients with sleep-di sordered breathing. Patients: Thirty-four consecutive patients of whom 25 (22 men and 3 women; mean age, 49 years) participated in the follo w-up. All patients had obstructive sleep apnea syndrome. Intervention: Uvulopalatopharyngoplasty. Main Outcome Measures: Symptoms and apneah ypopnea index (AHI) before and after UPPP. Response to treatment defin ed as a 50% or more reduction in AHI and a postoperative AHI of 10 or less. Results: Reduced prevalence of snoring and daytime sleepiness an d reduction in AHI (mean [+/-SD], 40+/-26 to 21+/-21) at follow-up (P< .001). Sixteen patients (64%) were responders after 6 months and 12 (4 8%) at the long-term follow-up. Responders had a lower preoperative AH I (25+/-7) than did nonresponders (48+/-29) (P<.05). None of the 7 pat ients with preoperative AHI of more than 40 were responders (P<.01). N o difference was seen in preoperative body mass index, lung function, ventilatory response to carbon dioxide, computed tomography scan of up per airways, or change in body mass index between responders and nonre sponders. Conclusions: Four to 8 years after UPPP, about half of our p atients were clinically and objectively improved. Uvulopalatopharyngop lasty should be reserved for patients with mild or moderate obstructiv e sleep apnea. After UPPP, long-term follow-up is recommended because some initially successfully treated patients will relapse in the long term.