Postoperative Risk following Uvulopalatopharyngoplasty for Obstructive Sleep Apnea

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Abstract
A study was conducted to assess oxygenation and respiratory changes on the first and second postoperative nights after uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea (OSA). Twelve patients were postoperatively evaluated with 8-hour nocturnal polysomnography on four occasions: (1) PREOP—night before UPPP, (2) POPN1—first postoperative night, (3) POPN2—second postoperative night, and (4) 3MOS—3-month follow-up study. Results demonstrate that apnea Index (Al) and respiratory disturbance Index (RDI) were significantly Improved at 3MOS from PREOP levels: Al (p < 0.01) and RDI (p < 0.05). There were no statistical differences from PREOP to POPN1 or POPN2 for Al, RDI, lowest oxyhemoglobin saturation (LSAT), or number of desaturations (#DESAT). One of twelve patients dropped LSAT >10% from PREOP to POPN1 or POPN2 (82% PREOP to 71% POPN2). Patients were grouped by PREOP LSAT ⩾80% or p = 0.02). These data suggest that in the majority of patients, preoperative indices remain unchanged for at least 2 days after surgery, even for patients who demonstrated improvement at 3 months. However, worsening does occur in some patients. On the basis of the results of this study and clinical experience with the postoperative course, a selective management protocol is outlined.