Laser-assisted uvulopalatoplasty for the treatment of mild, moderate, and severe obstructive sleep apnea

Objectives/Hypothesis: Until recently, laser-assisted uvulopalatoplasty (LA UP) has been used to treat only snoring and mild cases of obstructive sleep apnea (OSA). The purpose of this study was to evaluate the efficacy and sa fety of LAUP in patients with mild, moderate, and severe OSA. Study Design: A prospective study of 38 patients who completed LAUP for the treatment of OSA who were evaluated based on the severity level of their preoperative a pnea. Materials and Methods: Between July 1993 and December 1995, 96 patien ts with a diagnosis of OSA based on polysomnography underwent staged outpat ient LAUP treatment, Thirty-eight patients completed treatment and obtained postoperative polysomnography. Postoperative complications and polysomnogr aphic findings were reviewed. Results: Fifteen patients had a diagnosis of mild apnea, 12 had moderate apnea, and II had severe apnea based on preoper ative polysomnography. The surgical response rates, defined as greater than or equal to 50% reduction in the postoperative respiratory disturbance ind ex (RDI) and a postoperative RDI of less than 20, were 46.7% in the mild ap neics, 41.7% in the moderate apneics, and 45.5% in the severe apneics, Post operative complications in this series included minor bleeding, oral candid iasis, and temporary velopharyngeal insufficiency. There were no serious co mplications. Conclusions: In the carefully selected and prepared patient wi th mild, moderate, or severe OSA, LAUP should be considered a surgical opti on for the treatment of this disorder. LAUP remains a cost-effective and sa fe alternative to uvulopalatopharyngoplasty.