Effect of uvulopalatopharyngoplasty on retropalatal region

Abstract

Flexible optic laryngoscopy (FOL) allows us to visualize the obstructive sleep apnea (OSA)-related airway passages. Retropalatal region is a part of upper airway contributing to the OSA. We aimed to demonstrate the changes in the retropalatal surface area (RPSA) after submucosal uvulopalatopharyngoplasty (smUPPP) in an attempt to exhibit enlargement as a predictor of surgical treatment. It is a prospective, case-control study and conducted at the Otolaryngology department in a university hospital. Twenty patients with OSA who underwent smUPPP were prospectively evaluated. Pre and postoperative respiratory disturbance index (RDI) and RPSA measurements were studied. Retropalatal region videos were obtained at the base of uvula during FOL. Photographic images were captured at the same level of a virtual horizontal line passing through the base of uvula posteriorly to measure RPSAs using AutoCad2004. RDI levels, RPSA measurements were compared using paired t test. Twenty patients underwent smUPPP. There were 17 (85 %) male and 3 (15 %) female. The mean age was 37 years. The RPSA measurements were between 18.41 and 144.102 (mean 63.39) preoperatively. The RPSA measurements were between 83.784 and 255.463 (mean 143.87) postoperatively. The RPSA measurements were significantly enlarged postoperatively (p < 0.0005). The mean RPSA increased from 63.39 ± 29.3 to 143.82 ± 57.8. The mean RDI decreased from 22.95 ± 19.2 to 9.0 ± 8.2 (p = 0.011). RPSA increases in smUPPP patients postoperatively, evidencing enlarged retropalatal region. Decreased RDI levels indicate amelioration in OSA. RPSA measurements can be used to predict UPPP surgical treatment success.