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Comparative evaluation of surgical modalities in cases with obstructive sleep apnea syndrome

Manish Sharma, Om Prakash, Mohit Goel.

Abstract
Background: Sleep apnea is divided into three main types: central sleep apnea syndrome (CSAS), obstructive sleep apnea syndrome (OSAS), and mixed sleep apnea syndrome (MSAS). OSAS is responsible for 80% of cases of sleep apnea.

Objective: To determine the surgical outcome in patients with obstructive sleep apnea (OSA) following classical uvulopalatopharyngoplasty (UPPP) and modified UPPP and to compare the long-term results of surgery with nasal continuous positive airway pressure (n-CPAP) therapy.

Materials and Methods: Twenty-four diagnosed cases of OSAS were included in this study. These cases were divided into three groups of equal sizes (eight cases each). Cases in group I were subjected to modified UPPP, group II cases were subjected to classical UPPP, and group III were subjected to CPAP therapy.

Results: There were only 2 female patients out of 24 cases (8.33%). All the male patients were alcoholic (n = 22), and out of the 24 cases 41.66% (n = 10) were smokers. The cephalometry analysis of these patients was as follows: the mean distance from mandibular plane to hyoid bone in group I patient was 22 mm, group II 20.37 mm, and group III 20.87 mm. The mean posterior airway space in group I was 11.37 mm, group II was 11.12 mm, and group III was 11.75 mm. The mean length of soft palate in group I was 47.75 mm, group II was 42.62 mm, and group III was 45.37 mm. Out of the 24 patients in our study 16 underwent surgical treatment.

Conclusion: About 80%90% of our patients of group I were satisfied subjectively at 1-month follow-up. About 66%75% of group II patients were also satisfied at 1-month follow-up. About 95%100% of group III patients were also free of symptoms of OSA who were using CPAP daily.

Key words: Apnea, cephalometry, continuous positive airway pressure, uvulopalatopharyngoplasty



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