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Sleep Medicine

(399) Predictors of Uvulopalatopharyngoplasty Outcomes in Supine Predominant Positional OSA

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
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    Presenting Author(s)

  • Di Zhao, MD

    None
    The Second Affiliated Hospital,School of Zheijiang University
    HangZhou, Zhejiang, China (People's Republic)

    • Senior Author(s)

  • Di Zhao, MD

    None
    The Second Affiliated Hospital,School of Zheijiang University
    HangZhou, Zhejiang, China (People's Republic)

    • Co-Author(s)

  • Yl

    Yanru li, MD

    Attending Physician
    Beijing Tongren Hospital
    Beijing, Beijing, CHN

  • ZL

    Zhihong Ling, PhD

    The Second Affiliated Hospital,School of Medicine , Zhejiang University,, USA

  • yz

    ying zhang, MBA

    School of Medicine , Zhejiang University, USA

  • JY

    Jingying Ye, MD

    Beijing Tsinghua Chang Gung Hospital, Beijing, CHN

Disclosure(s):
Di Zhao, MD: No relevant relationships to disclose.


Introduction: Numerous studies have evaluated the influence of position-dependency（ SP-OSA） on Uvulopalatopharyngoplasty（UPPP）outcomes in OSA patients. However, it is uncertain which factors substantially influence outcomes after UPPP in SP-OSA patients.Therefore, this study aims to explore the anatomy and physiology predictors of uvulopalatopharyngoplasty (UPPP) outcomes in patients with SP-OSA.

Methods: This prospective observational study enrolled male patients with OSA who underwent UPPP at Beijing Tongren Hospital, Capital Medical University, and the Second Affiliated Hospital, School of Medicine, Zhejiang University, between October 2014 and September 2020. The patients were categorized into responders and non-responders based on the postoperative changes in apnea-hypopnea index (AHI).A total of 52 male SP-OSA patients (30 responders, median age: 39 years and 22 non-responders, median age: 36 years) were included.All statistical analyses were conducted using commercial software SPSS 21.0 (IBM, Armonk, NY, USA).

Results: There were statistically significant differences between responders and non-responders in body mass index (BMI), preoperative supine AHI, and time of SaO2 < 90% (TS90) (all P < 0.05). The responders had significant bigger tonsils (P < 0.001), wider minimal anteroposterior airway (mAP) (P = 0.016), minimal lateral airway (mLAT) (P = 0.002), minimal cross-sectional airway area (mCSA) (P < 0.001) at the velopharynx and wider mLAT (P = 0.014) and mCSA (P = 0.002) at the glossopharynx. Multivariate logistic regression showed BMI (OR: 1.077; 95% CI: 1.043-1.111, P < 0.001), mAP (OR: 1.213, 95% CI: 1.144-1.286, P < 0.001) and mLAT (OR: 1.089, CI: 1.032-1.049, P = 0.002) at velopharynx, and mCSA (OR: 1.004, 95% CI: 1.002-1.006, P < 0.001) at glossopharynx were independent predictors of UPPP response.

Conclusions: SP-OSA patients with lower BMI, mLAT and mAP at velopharynx, and mCSA at glossopharynx were more likely to achieve response after treated with UPPP.