Clinical variables affecting successful outcomes in OSAS palatal surgery

Abstract

Objectives: Obstructive sleep apnea impacts the entire body, leading to additional comorbidities that restrict life. In this study, the authors aimed to investigate the effectiveness of surgeries in patients who underwent palatal surgery for obstructive sleep apnea and examine the factors influencing surgical success by evaluating the clinical and polysomnography results of the patients. Methods: The data of patients who underwent palatal surgery for obstructive sleep apnea were analyzed retrospectively. Demographic data, physical examination findings, type of operation, postoperative follow-up periods, preoperative and postoperative polysomnography results, and sleep quality scale scores were evaluated. Patients were evaluated and compared in 2 groups as patients who had successful and unsuccessful surgery based on their surgical results. Surgical success criteria considered postoperative apnea as a decrease in the apnea-hypopnea index (AHI) by 50% or more compared with the preoperative value, along with a decrease in AHI below 15. Results: Of the 58 patients included in the study and evaluated according to the success criteria, 81% (n=47) were successful, and 19% (n=11) were unsuccessful. In the unsuccessful group, the sleep duration values of oxygen saturation below 90%, within the range of 80% to 90%, and within the range of 70% to 80% in preoperative PSG were significantly higher than those in the successful group. In addition, there was no significant difference in preoperative PSG data and clinical scores between the successful and unsuccessful groups. A significant positive correlation was identified between preoperative BMI and oxygen desaturation (sleep time below 90%) in preoperative PSG. A significant improvement was noted in all values of the successful group, except for sleep latency, during the postoperative period compared with the preoperative period. Conclusion: Although palatal surgeries appear to be an effective treatment for obstructive sleep apnea when performed with the appropriate indication and technique, the success of these surgeries is more significantly influenced by preoperative oxygen desaturation values than by preoperative AHI in PSG. If a possible new severity classification is developed for OSA in the future, our study supports including oxygen desaturation values in this classification alongside apnea and hypopnea numbers.