Long-term Efficacy of Uvulopalatopharyngoplasty among Adult Patients with Obstructive Sleep Apnea: A Systematic Review and Meta-analysis
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Mu He, MD*, Guoping Yin, MD*, Siyan Zhan, PhD, Jinkun Xu, MA, Xin Cao, MA, Jingjing Li, MA, Jingying Ye, MD First Published June 11, 2019 Review Article
https://doi.org/10.1177/0194599819840356
Article information
Article has an altmetric score of 1 No Access
Abstract
Objectives
To evaluate the long-term efficacy and potential predictors of uvulopalatopharyngoplasty (UPPP) among adult patients with obstructive sleep apnea (OSA).
Data Sources
A systematic search was conducted through PubMed/Medline, Embase, Web of Science, and the Cochrane Library until December 2018.
Review Methods
Full-text articles were selected that studied adult patients who underwent single-level UPPP or its modification for OSA and had a long-term follow-up (at least 34 months) with objective sleep study results. Studies that had no objective outcomes or performed other surgical procedures for OSA were excluded.
Results
Of 2600 studies, 11 were included. Meta-analysis comparing long-term post- and preoperative outcomes showed significant improvements, with an 15.4 event/h (46.1%) decrease of apnea-hypopnea index. Compared with the short-term outcomes (3-12 months), the long-term outcomes were less effective, with apnea-hypopnea index increasing 12.3 events/h (63.8%) and the surgical response decreasing from 67.3% to 44.35%. Subanalysis of individual patient data showed significant correlations of baseline body mass index, lowest arterial oxygen saturation, and proportion of sleep time with oxygen saturation <90% with long-term surgical response.
Conclusions
Despite the surgical efficacy decreasing over time, UPPP and its modification are an effective surgical method for adult OSA in both the short term and the long term after the surgery. Baseline body mass index, lowest arterial oxygen saturation, and proportion of sleep time with oxygen saturation <90% were potentially predictive for long-term surgical response. Case-control studies of the long-term surgical effect of OSA are needed.
Keywords obstructive sleep apnea, uvulopalatopharyngoplasty, long-term outcome, surgical success rate, surgical cure rate, meta-analysis, systematic review
Show less
Mu He, MD*, Guoping Yin, MD*, Siyan Zhan, PhD, Jinkun Xu, MA, Xin Cao, MA, Jingjing Li, MA, Jingying Ye, MD First Published June 11, 2019 Review Article
https://doi.org/10.1177/0194599819840356
Article information
Article has an altmetric score of 1 No Access
Abstract
Objectives
To evaluate the long-term efficacy and potential predictors of uvulopalatopharyngoplasty (UPPP) among adult patients with obstructive sleep apnea (OSA).
Data Sources
A systematic search was conducted through PubMed/Medline, Embase, Web of Science, and the Cochrane Library until December 2018.
Review Methods
Full-text articles were selected that studied adult patients who underwent single-level UPPP or its modification for OSA and had a long-term follow-up (at least 34 months) with objective sleep study results. Studies that had no objective outcomes or performed other surgical procedures for OSA were excluded.
Results
Of 2600 studies, 11 were included. Meta-analysis comparing long-term post- and preoperative outcomes showed significant improvements, with an 15.4 event/h (46.1%) decrease of apnea-hypopnea index. Compared with the short-term outcomes (3-12 months), the long-term outcomes were less effective, with apnea-hypopnea index increasing 12.3 events/h (63.8%) and the surgical response decreasing from 67.3% to 44.35%. Subanalysis of individual patient data showed significant correlations of baseline body mass index, lowest arterial oxygen saturation, and proportion of sleep time with oxygen saturation <90% with long-term surgical response.
Conclusions
Despite the surgical efficacy decreasing over time, UPPP and its modification are an effective surgical method for adult OSA in both the short term and the long term after the surgery. Baseline body mass index, lowest arterial oxygen saturation, and proportion of sleep time with oxygen saturation <90% were potentially predictive for long-term surgical response. Case-control studies of the long-term surgical effect of OSA are needed.
Keywords obstructive sleep apnea, uvulopalatopharyngoplasty, long-term outcome, surgical success rate, surgical cure rate, meta-analysis, systematic review
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