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Complications of palatoplasty for snoring or sleep apnoea

Published online by Cambridge University Press:  29 June 2007

W. C. Lee ,
D. W. Skinner  and
A. J. N. Prichard
W. C. Lee*
Affiliation:
Department of Otolaryngology, Eye, Ear and Throat Hospital, Shrewsbury, UK.
D. W. Skinner
Affiliation:
Department of Otolaryngology, Eye, Ear and Throat Hospital, Shrewsbury, UK.
A. J. N. Prichard
Affiliation:
Department of Otolaryngology, Eye, Ear and Throat Hospital, Shrewsbury, UK.
*
Address for correspondence: Mr W. C. Lee, Department of Otolaryngology, Russells Hall Hospital, Dudley DY1 2HQ. Fax: 01384 244169
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Abstract

A questionnaire was sent to consultant Otolaryngologists (483) throughout the UK to identify any mortality associated with uvulopalatoplasty and other forms of palatoplasties for snoring and/or obstructive sleep apnoea. The response rate was 76.8 per cent (371). Six intra- and post-operative deaths were reported and four were known to have obstructive sleep apnoea. Life-threatening morbidity occurred in at least seven patients (three known apnoeic), two required immediate tracheostomy and two were managed in the intensive care unit. This suggests that the apnoeic patients undergoing palatoplasties experienced significant mortality and morbidity. Pre-operative sleep study should be performed in all snoring patients to identify the apnoeic subgroup. Continuous positive airway pressure, management of excessive obesity, elective tracheostomy and other strategies should be first considered before palatoplasties in these patients.

Keywords

MorbidityMortalityPalatesoftSleep apnoea syndromesSurgeryoperative
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 12 , December 1997 , pp. 1151 - 1154
Copyright
Copyright © JLO (1984) Limited 1997

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References

Aboussouan, L. S., Golish, J. A., Wood, B. G. (1994) Obstructive sleep apnoea. Warding off the sometimes dire consequences. Postgraduate Medicine 96:115–116, 119–123.CrossRefGoogle ScholarPubMed
Bradley, T. D., Rutherford, R., Grossman, R. F., Lue, F., Zamel, N., Moldofsky, H., Phillipson, E. A. (1985) Role of daytime hypoxemia in the pathogenesis of right heart failure in the obstructive sleep apnea syndrome. American Review of Respiratory Diseases 131: 835–839.Google ScholarPubMed
Croft, C. B., Golding-Wood, D. G. (1990) Uses and complications of uvulopalatopharyngoplasty. Journal of Laryngology and Otology 104: 871–875.CrossRefGoogle ScholarPubMed
Davis, J. A., Fine, E. D., Maniglia, A. J. (1993) Uvulopalatopharyngoplasty for obstructive sleep apnoea in adults: clinical correlation with polysomnographic results. Ear, Nose and Throat Journal 72: 63–66.CrossRefGoogle ScholarPubMed
Dodds, C. (1994) Sleep apnoea and anaesthesia. In Recent Advances in Anaesthesia and Analgesia (Atkinson, R. S., Adams, A. P., eds.) Churchill Livingston, Edinburgh, pp 179–197.Google Scholar
Fairbanks, D. N. (1990) Uvulopalatopharyngoplasty complications and avoidance strategies. Otolaryngology - Head and Neck Surgery 102: 239–245.CrossRefGoogle ScholarPubMed
Fairbanks, D. N. (1993) Uvulopalatopharyngoplasty: strategies for success and safety. Ear, Nose and Throat Journal 72: 46–47, 50–51.CrossRefGoogle ScholarPubMed
Finkelstein, Y., Talmi, Y. P., Raveh, E., Odin, J., Rudnicki, C., Fried, M. (1995) Can obstructive sleep apnoea be a complication of uvulopalatopharyngoplasty? Journal of Laryngology and Otology 109: 212–221.CrossRefGoogle ScholarPubMed
Fletcher, E. C., Schaaf, J. W., Miller, J., Fletcher, J. G. (1987) Long-term cardiopulmonary sequelae in patients with sleep apnoea and chronic lung disease. American Review of Respiratory Diseases 135: 525–533.Google ScholarPubMed
Fujita, S., Conway, W., Zorick, F., Roth, T. (1981) Surgical correction of anatomic abnormalities in obstructive sleep apnoea syndrome; uvulopalatopharyngoplasty. Otolaryngology - Head and Neck Surgery 89: 923–934.CrossRefGoogle Scholar
Haavisto, L., Suonpaa, J. (1994) Complications of uvulopalatopharyngoplasty. Clinical Otolaryngology 19: 243–247.CrossRefGoogle ScholarPubMed
Haraldsson, P. O., Carenfelt, C., Diderichsen, F., Nygren, A., Tingvall, C. (1990) Clinical symptoms of sleep apnoea syndrome and automobile accidents. Journal of Otorhinolaryngology and its Related Specialties 52: 57–62.CrossRefGoogle ScholarPubMed
Harmon, J. D., Morgan, W., Chaudhary, B. (1989) Sleep apnoea: morbidity and mortality of surgical treatment. Southern Medical Journal 82: 161–164.CrossRefGoogle ScholarPubMed
He, J., Kryger, M. H., Zorick, F. J., Conway, W., Roth, T. (1988) Mortality and apnea index in obstructive sleep apnea. Experience in 385 male patients. Chest 94: 9–14.CrossRefGoogle ScholarPubMed
Jason, C., Gislason, T., Bengtsson, H., Eriksson, G., Lindberg, E., Lindholm, G., Hultcrantz, E., Hetta, J., Boman, G. (1997) Long-term follow-up of patients with obstructive sleep apnea treated with uvulopalatopharyngoplasty. Archives of Otolaryngology - Head and Neck Surgery 123: 257–262.CrossRefGoogle Scholar
Keenan, S. P., Burt, H., Ryan, C. F., Fleetham, J. A. (1994) Long-term survival of patients with obstructive sleep apnoea treated by uvulopalatopharyngoplasty or nasal CPAP. Chest 105: 155–159.CrossRefGoogle ScholarPubMed
Koskenvuo, M., Partinen, M., Kaprio, J., Vuorinen, H., Telakivi, T., Kajaste, S., Salmi, T., Heikkila, K. (1994) Snoring and cardiovascular risk factors. Annals of Medicine 26: 371–376.CrossRefGoogle ScholarPubMed
Larsson, H., Carlsson-Nordlander, B., Svanborg, E. (1991) Long-time follow-up after UPPP for obstructive sleep apnea syndrome. Acta Otolaryngology (Stockh) 111: 582–590.CrossRefGoogle ScholarPubMed
Palomaki, H., Partinen, M., Erkinjuntti, T., Kaste, M. (1992) Snoring, sleep apnoea syndrome, and stroke. Neurology 42: 75–81.Google ScholarPubMed
Prichard, A. J., Marshall, J., Ahmed, A., Thomas, R. S., Hanning, C. D. (1994) Uvulopalatopharyngoplasty: The Leicester experience. Journal of Laryngology and Otology 108: 649–652.CrossRefGoogle ScholarPubMed
Prichard, A. J. N., Smithson, A. J., White, J. E. S., Close, P. R., Drinnan, M. J., Griffiths, C. J., Marshall, H. F., Gibson, G. J. (1995) Objective measurement of the results of uvulopalatopharyngoplasty. Clinical Otolaryngology 20: 495–498.CrossRefGoogle ScholarPubMed
Rodenstein, D. O. (1992) Assessment of uvulopalatopharyngoplasty for the treatment of sleep apnoea syndrome. Sleep 15: S56–62.CrossRefGoogle Scholar
Ryan, C. F., Lowe, A. A., Li, D., Fleetham, J. A. (1991) Magnetic resonance imaging of the upper airway in obstructive sleep apnoea before and after chronic nasal continuous positive airway pressure therapy. American Review of Respiratory Diseases 144: 939–944.CrossRefGoogle ScholarPubMed
Spriggs, D. A., French, J. M., Murdy, J. M., Curless, R. H., Bates, D., James, O. F. (1992) Snoring increases the risk of stroke and adversely affects prognosis. Quarterly Journal of Medicine 83: 555–562.Google ScholarPubMed