Comparison of preoperative and postoperative symptoms, examinations and laboratory findings of pati̇ents undergoing palatal surgery for obstruktive sleep apnea

Objective: Obstructive sleep apnea syndrome(OSAS) is a chronic disease characterized by apnea and hypopnea occurring due to repetitive collapses of the upper respiratory tract during sleep, accompanied by sleep interruptions and daytime sleepiness. OSAS causes comorbid diseases such as cardiovascular disease, stroke and metabolic syndrome. It impairs the quality of life of patients and may lead to work and traffic accidents. In our study, it was aimed to investigate the effectiveness of surgeries performed in OSAS patients who were operated with the indication of palatal surgery. Method: In this study, the data of 58 patients who underwent palatal surgery for OSAS in our clinic were reviewed retrospectively. Demographic data, Body Mass Index(BMI), neck circumference, type of operation performed and follow-up times of patients was recorded. Preoperative and postoperative polysomnography(PSG) and physical examination findings, Epworth sleepiness scale and Pitsburg sleep quality scale scores were evaluated. A decrease of %50 or more in the postoperative AHI value compared to the preoperative AHI value and a postoperative AHI value below 15 were accepted as surgical success criteria and the patients were evaluated according to these criteria. Results: Among the patients who underwent palatal surgery, 47 patients were successful and 11 patients were unsuccessful. In the unsuccessful group, the percentage of sleep time with oxygen saturation in the range of %70-80, %80-90 and below %90 in preoperative PSG were found to be significantly higher than the successful group. There was no significant difference between successful and unsuccessful groups in other preoperative PSG data and sleepiness scale scores. A positive and weakly significant correlation was found between preoperative BMI and the percentage of sleep time with oxygen saturation below 90% in preoperative PSG. Values other than sleep latency of the successful group showed significant improvement in the postoperative period compared to the preoperative period. In the unsuccessful group, there was no significant difference between the preoperative and postoperative PSG and sleepiness scale datas. Conclusion: Palatal surgeries performed with appropriate indications seem to be an effective treatment modality for OSAS today. The severity of OSAS and the effectiveness of palatal surgeries should be evaluated not only with the apnea-hypopnea index(AHI) but also with other PSG parameters, especially oxygen desaturation. Keywords: Obstructive sleep apnea syndrome, snoring, polysomnography