Change of the pharyngeal airway after UPPP

• Published in: Stomato-pharyngology Vol. 9; no. 3; pp. 417 - 422
• Main Authors: Itasaka, Yoshiaki, Ishikawa, Kazuo, Togawa, Kiyoshi, Tada, Hiroyuki, Yokomizo, Michinori, Miyazaki, Soichiro
• Format: Journal Article
• Language: Japanese
• Published: Japan Society of Stomato-pharyngology 1997; 日本口腔・咽頭科学会
• Subjects: cephalometry; obstructive sleep apnea; upper airway pressure measurement; UPPP; セファロメトリー; 気道内圧測定; 睡眠時無呼吸; 軟口蓋形成術
• ISSN: 0917-5105; 1884-4316
• DOI: 10.14821/stomatopharyngology1989.9.417

Uvulo-palato-pharyngo-plasty (UPPP) is the most popular surgical technique to treat obstructive sleep apnea. However the ratio of improvement after UPPP is only about 50%. We evaluated the change of the soft palate after UPPP in order to find the reason for UPPP failure. The cephalometric data of the 33 UPPP cases (27 male, 6 female) were analyzed. The length and thickness of the soft palate were evaluated according to the period after UPPP [group 1 (n=15), less than 6 months; group 2 (n=8), 7 months-2 years; group 3 (n=10), over 2 years]. The site of obstruction after UPPP was examined in 16 cases of the 33 subjects using upper airway pressure measurement. As a result, the soft palate shortened from 39.3mm to 31.2mm after UPPP in all 33 cases . The length of the soft palate in groups 1 and 2 became significantly shorter compared with the preoperative length. However, after 2 years (group 3), the length of the soft palate was not significantly short compared to the preoperative length. The soft palate changed its thickness from 11.2mm to 13.2mm postoperatively in all 33 cases. The soft palate in groups 1 and 3 was significantly thick compared to the preoperative thickness. With the pressure measurement, we found residual obstruction in the soft palate after UPPP in 3 out of 7 UPPP failures. Thus, we concluded that some UPPP failures may have the thickened soft palate which cause residual obstruction at the level of the soft palate after surgery.