Nonresection laser uvulopalatoplasty in patients with OSA

Relevance. The main method of treating patients with severe and moderate OSA is CPAP therapy, however, it is important to choose therapy for patients with contraindications, low compliance to CPAP therapy or rejection of it. Surgical treatment is effective when significant upper respiratory tract obstruction can be eliminated, and minimally invasive techniques are preferred. Nonresection laser uvulopalatoplasty has proven to be an effective method of treating ronchopathy. Currently, there are no studies devoted to evaluating the effectiveness of this treatment method in patients with OSA. Objective: to evaluate the efficacy, safety, and tolerability of laser nonresection uvulopalatoplasty in patients with OSA. Materials and methods. 58 patients with OSA were examined with failure or poor tolerance of CPAP therapy or lack of indications after performing laser nonresection uvulopalatoplasty according to the following plan: otorhinolaryngological examination on days 1,7,14 and 30 after surgery, thermometry, assessment of complaints, subjective sensations and pain syndrome on a visually analog scale, somnological examination, transnasal fibrolaryngoscopy with the Muller test, questionnaire. Results. The dynamics of pain syndrome and local inflammatory manifestations in the area of laser exposure increased as much as possible by the third day of the postoperative period and subsided by 7-10 days after surgery. Subjectively, all patients noted an improvement in well-being according to the results of the quality of life assessment questionnaire (SF-36), a decrease in daytime sleepiness (on the Epworth scale), as well as a decrease in the risk of developing OSA on the STOP-BANG scale and the Berlin questionnaire. According to the results of the control somnological examination in the postoperative period: in 23 patients, IAG became less than 5, in 20 patients IAG decreased by more than 50%, in 11 patients IAG decreased by less than 50%. According to the results of the somnological examination, the dynamics of 4 people was negative. Conclusion. Nonresection laser uvulopalatoplasty can be successfully used in some patients with OSA. Somnological examination in the postoperative period cannot be the only objective criterion for the effectiveness of surgical treatment of patients with OSA.