Upper Airway CT Predict Velopharyngeal Change The Long-term Efficacy Of Angioplasty And Postoperative Efficacy And Airway Form

Charter1. Computed Tomography in Predicting Long-term Outcome ofPalatopharyngoplasty for Moderate and Severe Obstructive Sleep ApneaObjectives To investigate the value of computed tomography (CT) in predictingthe outcome of uvulopalatopharyngoplasty (UPPP).Material and methods Twenty-one patients with moderate and severeobstructive sleep apnea syndrome (OSAS) underwent CT scanning during sleep andwakefulness preopratively. According to CT measurements, patients were divided intogroup A with retropalatal (RP) obstruction and group B with retropalatal (RP) andretroglossal (RL) obstructions. All patients accepted UPPP. Postoperative follow-up was atleast17months. The success rate of the two groups was compared,and the predictivevalues of the CT scanning during sleep and wakefulness were analyzed.Results The postoperative subjective and objective outcomes were improved. Theoverall success rate of UPPP was52.38%. The success rate in group A was significantlyhigher than group B (75%vs.22.22%when the groups were divided by CT scanningduring sleep;87.71%vs.35.71%when the groups were divided by CT scanning duringwakefulness). The predictive values were sensitivity of81.82%, specificity of70%,positive predictive value (PPV) of75%, and negative predictive value (NPV) of77.8%byCT during sleep,54.5%,90%,85.7%,64.3%by CT during wakefulness.Conclusions Preoperative CT scanning, whether during wakefulness or sleep, is areliable method in predicting long-term outcome of UPPP. Charter2. The Relationship between Upper Airway MorphologicalChanges and Long-term Efficacy after PalatopharyngoplastyObjective To study the relationship between morphological changes of the upperairway and long term efficacy after palatopharyngoplasty in obstructive sleep apneahypopnea syndrome (OSAHS) patients.Methods21patients with moderate to severe OSAHS were enrolled in this study,and their upper airways were scanned by CT before and17~34months afterpalatopharyngoplasty. The changes between pre-and postoperative upper airways werecompared, and the relation between these changes and the parameters monitored bypolysomnography (PSG) was analyzed.Results The lateral dimensions and minimal cross-sectional areas (mCSA) ofretropalatal (RP) areas were increased, whereas the anteroposterior dimensions ofretroglossal (RL) areas were decreased after surgery. Furthermore, the elliptically shapedairway with its long axis oriented in the anteroposterior direction was changed into theairway oriented with its long axis oriented in the lateral dimension. In responded group, thechanges of AHI had a negative correlation with the changes of lateral measurements andmCSA of RP areas(R2=-0.560, P=0.037; R2=-0.645, P=0.016).Conclusion The effect of palatopharyngoplasty may be correlated with theincrease of the lateral diameters and mCSA of RP areas, and the changes of the shape ofthe upper airway.