Risk Factors in Sleep Apnea Surgery

Patients undergoing surgery to correct sleep apnea are more likely to have complications if their condition is severe, they have a high body mass index (BMI), or they have other medical problems, according to a new study.

Researchers form the University of California, San Francisco (UCSF, USA), studied 3,130 consecutive adults (97% men, average age 50) who underwent uvulopalatopharyngoplasty (UPPP) for sleep apnea between 1991 and 2001 at United States Veterans Affairs (VA) medical centers. The researchers gathered data about participants' surgeries and characteristics from medical records, including the severity of sleep apnea, BMI, other illnesses, and surgical procedures performed at the same time.

Patients who had more severe sleep apnea, who had additional non-nasal surgeries at the same time, and who had other medical conditions were more likely to have serious complications following surgery. For each additional illness besides sleep apnea that a patient had, his or her risk for complications almost doubled. In a smaller group of 267 patients, more severe sleep apnea, higher body mass index, and the presence of other illnesses were associated with a higher risk for complications when they were all considered together. Having retrolingual surgery (certain procedures involving the tongue, epiglottis, or jaw) at the same time as UPPP was independently associated with having complications following the operation. The results were reported in the October 2006 issue of Archives of Otolaryngology – Head & Neck Surgery.

"Apnea-hypopnea index, body mass index, and medical comorbidity were each associated with serious complication; however, the low complication rate precluded demonstration of associations independent of each other,” concluded Eric J. Kezirian, M.D., M.P.H, from UCSF, and colleagues. "Concurrent retrolingual procedures were also associated with serious complication, but the cumulative risk of separate retrolingual procedures is unknown.”

UPPP is a surgical resection of unnecessary palatal and oropharyngeal tissue to open the airway, intended to cure extreme cases of snoring (with or without sleep apnea).



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