Computer-aid designed UPPP for the obese patients with OSAS

Objectives: It is known to all that only 40-50% OSAS patients who have a good response to UPPP. It is the main reasons that there are multipoint narrow at upper airway, while UPPP can only relieved the narrow at the region behind soft palate, and how many tissue at soft palate and lateral pharynx to be removed is difficult to be determined. UPPP treatment may cause VPI and patients may be irritated while eating something, especially drinking and may have exorbitant rhinolalia when they speak. To reduce or eliminate these complications we applied the computer-aid designed UPPP for these patients. Methods: 78 cases with OSAS were evaluated by PSG, cephalometric analysis and speech examination pre- and post- operation. The average BMI was 32.56±5.16 and RDI was 45.34±27.36. Their age was from 32 to 57, with mean at 46. We took the lateral roentgenograms for them, when they were silent and continuously sounding /i/. We evaluated the narrow and occlusive site by using computer cephalometric analysis system.The velopharyngeal closure point and meter the distance form the point to top of uvula was found that the excessive soft tissue in this region could be resected safely.Results: Stanford success criteria was taken to evaluate these patients: a postoperative RDI of 20 or less and /or at least a reduction of the RDI of 50%. In addition, postoperative SaO² must be normal or only have a few minimal falls below 90%. There were 84.32% of the patients who had good response to this kind of UPPP, with the mean follow-up duration 19 months. Their RDI was 21.64±7.83.All the patients had a good velopharygeal closure. Conclusions: Computer-aid designed UPPP raises the success rate and decreases the complications remarkably.