PREDICTION OF UVULOPALATOPHARYNGOPLASTY RESPONSE USING CEPHALOMETRIC RADIOGRAPHS

Purpose: To evaluate the relationship between facial cephalometric mea sures and response to uvulopalatopharyngoplasty (UPPP). Patients and M ethods: Retrospective analysis of skeletal cephalometric measures obta ined from a consecutive sample of 43 patients with obstructive sleep a pnea syndrome (OSAS) who underwent body mass index (BMI) measures, UPP P, upright lateral cephalometric radiographs, and preoperative and pos toperative polysomnography. Significant clinical effect by uvulopalato pharyngoplasty was arbitrarily defined as having a 50% reduction in th e respiratory disturbance index (RDI). The cephalometric measurements used were based solely on skeletal landmarks. Results: No skeletal mea surement predicted response to UPPP for the entire study population, W hen the patients were classified on the basis of retrognathia, 33 were identified without retrognathia. In that group, posterior airway leng th was the greatest predictor of response to UPPP (P less than or equa l to .05; odds ratio, 83.2). The distance between hyoid and mandible a nd the maxillary-mandibular relationship were also predictive of respo nse (P less than or equal to .05). Conclusion: The skeletal anatomy su pporting the airway directly impacts the response to UPPP. Prediction of response requires stratification by skeletal subtype. Copyright (C) 1997 by W.B. Saunders Company.