Outcomes of uvulopalatopharyngoplasty with harmonic scalpel after failure of continuous positive airway pressure in sleep apnea syndrome.

Conclusions: Our data highlight that uvulopalatopharyngoplasty (UPPP) with harmonic scalpel (HS) is a reliable treatment in selected patients affected by obstructive sleep apnea (OSA) and users of continuous positive airway pressure (CPAP). Objectives: The aim of this paper was to verify the efficacy and applicability of UPPP with HS in the treatment of patients affected by OSA and users of CPAP. Methods: A total of 21 patients with a retropalatal obstruction and users of CPAP underwent UPPP with HS and were evaluated (before and 6 months after surgery) using the apnea/hypopnea index (AHI); oxygen desaturation index >= 4% (ODI4); Epworth Sleepiness Scale (ESS); snoring level (SL); subjective assessment of the postoperative pain on postoperative days 1, 3, and 10; and number of days until return to solid food. Results: Six months after surgery: AHI decreased significantly (p < 0.05) from 31.8 +/- 2.83 to 9.0 +/- 0.68; ODI4 was 2.1 +/- 0.4 vs a preoperative value of 24.0 +/- 1.9; ESS scores were also significantly decreased (p < 0.05) from 14.0 +/- 3.7 to 4.7 +/- 2.2; SL was significantly lower (p < 0.05) 1.6 +/- 0.3 vs 7.9 +/- 0.8. Postoperatively, patients experienced lower levels of pain and the median of time to return to normal diet was 3 days.