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Abstract #99621 Published in IGR 23-1
Systematic review and updated meta-analysis of multi-level surgery for patients with OSA
Su YY; Lin PW; Lin HC; Chang CT; Lin CY; Friedman M; Salapatas AMAuris Nasus Larynx 2022; 49: 421-430
OBJECTIVES: To perform an updated systematic review for determining the surgical success rate of multilevel upper airway surgery for patients with obstructive sleep apnea/hypopnea syndrome (OSA). METHODS: A systematic review was performed to identify English-language studies that evaluated the treatment of adult OSA patients with multilevel OSA surgery up to January, 2018. We used polysomnography as a metric of treatment success. Articles were only included if the surgery intervention involved at least two of the frequently involved anatomic sites: nose, oropharynx and hypopharynx. Eighty-seven studies fit the inclusion criteria and a meta-analysis was performed to determine the overall success. RESULTS: The meta-analysis included 3931 subjects with a mean age of 46.1 years. The originally reported success rate in the included literature was 59.9%. A meta-analysis was performed to redefine the success rate to be consistent with the commonly agreed upon criteria - namely "a reduction in apnea/hypopnea index (AHI, /hr.) of 50% or more and an AHI of less than 20". The recalculated success rate was 60.2%. Standard meta-analytic techniques for combining p-values between studies after weighting for sample size found significant improvements in AHI, apnea index, % of rapid eye movement sleep, lowest saturation of oxygen (%), and Epworth Sleepiness Scale. CONCLUSION: This study shows the significant improvement of treatment outcomes with multilevel surgery for OSA patients.
Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung; Chang Gung University College of Medicine, Taoyuan. 123, Ta-Pei Rd., Niao-Sung District, Kaohsiung, 833, Taiwan; Sleep Center, Kaohsiung Chang Gung Memorial Hospital.
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