DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20173689

A study on evaluation of pre and postoperative polysomnography for obstructive sleep apnea patients

Venugopal Mohankumar, M. K. Rajasekar, Narendrakumar Veerasigamani, M. Sivaranjani

Abstract


Background: Obstructive sleep apnea is the most common form of sleep-disordered breathing. However, obstructive sleep apnea has been associated with much more insidious conditions, including hypertension, diabetes, heart disease, stroke, and daytime somnolence can lead to a dramatically increased risk of motor vehicle accidents.

Methods: This study was conducted in our institution in 34 OSA patients. After thorough evaluation with PSG, dynamic MRI, DISE patients were treated with various surgeries depending on the level of obstruction. Commonly UPPP, ESP, zetaplasty, tonsillectomy, tongue base reduction were done either alone or in combination.  

Results: Pre and postoperative polysomnograhpy for obstructive sleep apnea was evaluated and statistically analyzed. Significant proportion of patients improved both subjectively and objectively as determined by reduction in AHI from 41.73±13.94 to 15.77±9.13, reduction in ESS from 16.41+3.09 to 5.14±3.41 and reduction in snoring.

Conclusions: OSA can be easily treated with proper preoperative investigations, appropriate surgery, prevention of complications and continued lifestyle modifications. 


Keywords


Epsworth sleepiness scale, Obstructive sleep apnea syndrome, Apnea hypopnea index, Body mass index

Full Text:

PDF

References


Remmers JE, deGroot WJ, Sauerland EK, Anch AM. Pathogenesis of upper airway occlusion during sleep. J Appl Physiol. 1978;44:931.

Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;32:1230–5.

Marshall NS, Wong KK, Liu PY, Cullen SR, Knuiman MW, Grunstein RR. Sleep apnea as an independent risk factor for all-cause mortality:the Busselton Health Study. Sleep. 2008;31:1079-85.

Tschopp K, Zumbrunn T, Knaus C, Thomaser E, Fabbro T. Statistical model for postoperative apnea–hypopnea index after multilevel surgery for sleep-disordered breathing. Eur Arch Otorhinolaryngol. 2011;268(11):1679-1685.

Browning GG, Gleeson M, Burton MJ, Clarke R, John H, Jones NS, et al. Scott-Brown’s otolaryngology head and neck surgery. 7th ed. Vol. 2. London: Hodder Arnold; 2008: 2305-2312.

Suto Y, Matsuo T, Kato T, Hori I, Inoue Y, Ogawa S, et al. Evaluation of the pharyngeal airway in patients with sleep apnea:value of ultrafast MR imaging. AJR Am J Roentgenol. 1993;160:311-4.

Friedman M, Ibrahim H, Bass L. Clinical staging for sleep-disordered breathing. Otolaryngol Head Neck Surg. 2002;127 (1):13-21.

Vanderveken OM, Maurer JT, Hohenhorst W, Hamans E, Lin HS, Vroegop AV, et al. Evaluation of drug-induced sleep endoscopy as a patient selection tool for implanted upper airway stimulation for obstructive sleep apnea. J Clin Sleep Med. 2013;9(5):433-8.

Khan A, Ramar K, Maddirala S, Friedman O, Pallanch JF, Olson EJ.. Uvulopalatopharyngoplasty in the Management of Obstructive Sleep Apnea. Mayo Clin Proc. 2009;84(9):795-800.

Janson C, Gislason T, Bengtsson H, Eriksson G, Lindberg E, Lindholm CE, et al. Long-term follow-up of patients with obstructive sleep apnea treated with uvulopalatopharyngoplasty. Arch Otolaryngol Head Neck Surg. 1997;123(3):257-62.

Pang KP, Woodson BT. Expansion sphincter pharyngoplasty:a new technique for the treatment of obstructive sleep apnea. Otolaryngol Head Neck Surg. 2007;137(1):110-4.

Whyte KF, Allen MB, Jeffrey AA, Gould GA, Douglas NJ. Clinical features of the sleep apnoea/ hypopnoea syndrome. Q J Med. 1989;72:659–66.

Den Herder C, Van Tinteren H, De Vries. Sleep endoscopy versus modified Mallampati score in sleep apnea and snoring. Laryngoscope. 2005;115:735-39.

Riley RW, Powell NB, Guilleminault C. Obstructive sleep apnea syndrome:a review of 306 consecutively treated surgical patients. Otolaryngol Head Neck Surg. 1993;108(2):117-25.

Abdullah VJ, Van Hasselt CA. Video Sleep Nasendoscopy. Surgical Management of Sleep Apnea and Snoring. In: Terris DJ, Goode RL, eds. Boca Raton, FL: Taylor & Francis; 2005: 143–154.

Elshaug AG, Moss JR, Southcott AM, Hiller JE. Redefining success in airway surgery for obstructive sleep apnea:a Meta-analysis and synthesis of the evidence. Sleep. 2007;30(4):461-7.

Lin HC, Friedman M, Chang HW, Gurpinar B. The efficacy of multilevel surgery of the upper airway in adults with obstructive sleep apnea/hypopnea syndrome. Laryngoscope. 2008;118(5):902-8.

Verse T, Kroker BA, Pirsig W, Brosch S. Tonsillectomy as a Treatment of Obstructive Sleep Apnea in adults with tonsillar hypertrophy. Laryngoscope. 2000;110:1556-9.

Esclamado RM, Glenn MG, McCulloch TM, Cummings CW. Perioperative complications and risk factors in the surgical treatment of obstructive sleep apnea syndrome. Laryngoscope. 1989;99(11):1125-9.

Vieira MBM, Leite SHP, Cunha FC. Zetapalatopharyngoplasty (ZPPP): New Surgical Tecnique for Snoring and Sleep Apnea Treatment. Braz J Otolaryngol. 2001: 1-8.

MacKay SG, Carney AS, Woods C, Antic N, McEvoy RD, Chia M, et al. Modified Uvulopalato-pharyngoplasty and Coblation Channeling of the Tongue for Obstructive Sleep Apnea:A Multi-Centre Australian Trial. J Clin Sleep Med. 2013;9(2):117-24.