• The Laryngoscope · Jun 2000

    Morbidly obese patients with severe obstructive sleep apnea: is airway reconstructive surgery a viable treatment option?

    • K K Li, N B Powell, R W Riley, A Zonato, L Gervacio, and C Guilleminault.
    • Stanford University Sleep Disorders and Research Center, California, USA. kaseyli@hotmail.com
    • Laryngoscope. 2000 Jun 1; 110 (6): 982-7.

    ObjectiveTo evaluate the outcomes of airway reconstructive surgery for the treatment of severe obstructive sleep apnea in the morbidly obese patient.MethodsRetrospective review of consecutively treated patients. Variables examined include age, sex, body mass index (BMI), respiratory disturbance index (RDI), lowest oxygen saturation (LSAT), cephalometric data, and complications.ResultsTwenty-one patients (13 men) with a mean age of 42.6 +/- 7.9 years and mean BMI of 45 +/- 5.4 kg/m2 were identified. The mean RDI improved from 83 +/- 30.1 to 10.6 +/- 10.8 events per hour with an improved mean apnea index from 38.4 +/- 31.3 to 1.2 +/- 1.8 events per hour. The mean LSAT improved from 63.9 +/- 17.7% to 86 +/- 7.9%. The mean BMI at the 6-month postoperative polysomnographic recording was 43 +/- 4.3 kg/m2 (P < .001). Seventeen patients (81%) were successfully treated (RDI < 20 and with minimal desaturation < 90%). The mean follow-up was 21.8 +/- 15.4 months (range, 7-66 mo). Coexisting obesity-hypoventilation syndrome was related to treatment failure in two patients. One patient noted recurrence of daytime fatigue after significant weight gain 4 years after surgery and the polysomnographic recordings demonstrated the recurrence of obstructive sleep apnea.ConclusionAirway reconstruction is an effective treatment for severe obstructive sleep apnea in the morbidly obese patient. Careful patient selection and identifying potential coexisting obesity-hypoventilation syndrome, as well as counseling on weight reduction and avoiding continual weight gain will improve treatment outcomes. Key Words: Obstructive sleep apnea, sleep-disordered breathing, obstructive sleep apnea surgery, obesity, maxillomandibular advancement.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…