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Surgical treatment of obstructive sleep apnea - comparison of the effectiveness of the most frequently performed procedures
Project IdSGS16/LF/2023
Main solverMUDr. Michaela Masárová
Period1/2023 - 12/2023
ProviderSpecifický VŠ výzkum
Statefinished
AnotationObstructive sleep apnea (OSA) is a serious disease that puts patients at high risk of developing cardiovascular disease. It is characterized by repeated episodes of complete or partial upper airway obstruction (UA) that lead to respiratory arrest during sleep. DISE (drug-induced sleep endoscopy) has been an integral part of OSA diagnostics in recent years, which helps to identify levels of obstruction and thus optimize the treatment of patients with OSA. DISE is usually performed before planned surgical treatment, which is mainly performed in patients with mild and moderate OSA. The main goal of surgical treatment is the patency of UA and the elimination of sleep apnea. The basis of the surgical plan for the treatment of OSA is the selection of the appropriate surgical intervention for the given specific patient. Correctly indicated surgical treatment of OSA achieves a high success rate (around 80%). The most common procedures include mainly uvulopalatopharyngoplasty (UPPP) with or without a procedure on the base of the tongue. UPPP shows good efficacy in reducing respiratory events with adequate indication. On the other hand, retrolingual surgery is less effective and at the same time associated with a relatively high risk of complications. UPPP itself has a certain risk of postoperative complications, such as bleeding, foreign body sensation, etc. According to the literature, the incidence of these complications is around 3.5%. However, if it is also associated with surgery in the retrolingual area, the risk of possible postoperative bleeding or edema in the area of the hypopharynx and larynx with potential aspiration or suffocation increases significantly. Currently, it is not sufficiently proven whether multilevel surgery really has better results in the treatment of OSA than UPPP alone. According to the first results of the studies, it appears that the results of individual procedures in a given group of patients could be comparable (with different risks).