Associated factors to predict outcomes of uvulopharyngopalatoplasty plus genioglossal advancement for obstructive sleep apnea

Objectives. This study aimed to evaluate the effectiveness of uvulopharyngopalatoplasty (UPPP) plus genioglossal advancement (GA) for severe obstructive sleep apnea (OSA) patients and to determine the predictive factors for surgical success. Study Design: Prospective case series. Methods: Patients with apnea-hypopnea index greater than 40/hour during an overnight sleep study and who were reluctant to receive nasal continuous positive airway pressure (nCPAP) therapy were included. Basic data were obtained along with physical examination, cephalometric measurements, and Epworth Sleepiness Score (ESS) questionnaire. All patients received UPPP plus GA under general anesthesia. Overnight sleep study was repeated at least 3 months after operation along with cephalometry and ESS questionnaire. Results: Forty-four patients with severe OSA were enrolled in this study. The overall success rate was 52.3%. Preoperative apnea index (AI) was the only significant predictor for the success of operation (P =.007). Furthermore, patients with AI less than 25/hour had a higher success rate than those with AI 25/hour or greater (odds ratio 13.1). Conclusion: Patients with AI less than 25/hour unwilling to receive nCPAP therapy could be more suitable for UPPP plus GA in terms of the success rate.