Surgical Outcomes

As noted previously, simply reducing the AHI by 50% is no longer considered a cure for SDB. Rather, surgical intervention aims to attain the results obtained by CPAP therapy. Consequently, a more comprehensive criterion was established to determine surgical success or cure (Table 3).

Clinical response to phase I surgery ranges from 42% to 75% (38,41-45). Our published data have shown that approximately 60% of all patients are cured with phase I surgery (38). Factors that portend less successful outcomes are a mean respiratory disturbance index (RDI) greater than 60, oxygen desaturation below 70%, mandibular deficiency (sella nasion point B < 75°) and morbid obesity [body mass index (BMI) > 33 kg/m2]. However, it is imprudent to forego phase I surgery in these patients, since a reasonable percentage may not require more aggressive surgery (37).

Incomplete treatment by phase I surgery is primarily related to persistent hypopharyngeal obstruction. Those patients who have failed treatment or who have been incompletely treated would then be considered for phase II surgery (MMO). MMO is a more aggressive surgery, which requires more intensive operative and postoperative care. Patients must be prepared for a recovery period of four to six weeks. Although the convalescence period may be extensive, documented success rates exceed 90% (38,46-49).

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Keep Your Weight In Check During The Holidays

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