Surgery and obstructive sleep apnea: Long-term clinical outcomes

OBJECTIVE: Outcome data on the surgical treatment of obstructive sleep apne a are, in general, based on short-term follow-up (<6-9 months). This examin ation was undertaken to assess long-term results. METHODS: Forty patients who underwent soft tissue and skeletal surgery were the subjects of this review. Methods of evaluation included polysomnograph ic variables (respiratory disturbance index (RDI), low oxyhemoglobin desatu ration (LSAT)), body mass index, quality-of-life assessments, roentgenograp hic analysis, and complications. Statistical analysis used the SAS 6.12 sys tem. RESULTS: Thirty-six of 40 patients (90%) showed longterm clinical success. The mean preoperative RDI, nasal continuous positive airway pressure RDI, a nd long-term RDI were 71.2 +/- 27.0, 7.6 +/- 5.2 and 7.6 +/- 5.1, respectiv ely. The mean preoperative LSAT, nasal continuous positive airway pressure LSAT, and longterm LSAT were 67.5% +/- 14.8%, 87.1% +/- 3.2%, and 86.3% +/- 3.9%, respectively. The mean follow-up was 50.7 +/- 31.9 months. The patie nts showed a statistically significant long-term weight gain (P = 0.0002) c ompared with their 6-month postoperative level (body mass index 31.4 +/- 6. 7 vs 32.2 +/- 6.3). There was a positive correlation with the amount of ske letal advancement and clinical outcome. CONCLUSION: Comprehensive evaluation and surgical treatment can result in s uccessful long-term clinical outcome.