OVULOPALATOPHARYNGOPLASTY FOR THE OBSTRUCTIVE SLEEP-APNEA SYNDROME - VALUE OF POLYSOMNOGRAPHY, MUELLER MANEUVER AND CEPHALOMETRY IN PREDICTING SURGICAL OUTCOME

Sixty consecutive patients with the obstructive sleep apnoea syndrome (53 men and seven women) were analysed by questionnaire, polysomnograp hy, rontgenographic cephalometry and the Mueller manoeuvre before and 6 months after uvulopalatopharyngoplasty (UPPP), to assess the surgica l outcome and the prognostic value of preoperative evaluation. Seventy -three per cent of patients reported improvement of snaring and 55% re ported improvement of excessive day-time sleepiness. Thirty-five per c ent showed a decrease of at least 50% in the desaturation index, and 1 3% had a postoperative desaturation index below 5. Although the improv ement of desaturation parameters was marked in some patients, the over all change was not significant. Neither the Body Mass Index (BMI), nor any of the cephalometric variables were significantly correlated to s urgical outcome. Increased difference in collapsibility between the so ft palate and the base of the tongue showed a close to significant rel ation with the improvement of desaturation index. High desaturation in dex, low mean saturation and deep lowest saturation were found to be s lightly predictive of improvement in nocturnal desaturation. In a mult ivariate analysis however no significant predictors could be identifie d. It is concluded that UPPP is effective in reducing snoring and dayt ime sleepiness over a 6-month follow-up period, but that the overall i mprovement in nocturnal desaturation is limited and difficult to predi ct. Further research is needed to evaluate the long-term efficacy of U PPP.