Staging of Obstructive Sleep Apnea/Hypopnea Syndrome: A Guide to Appropriate Treatment
Objective Early studies by Friedman et al. have demonstrated the value of staging obstructive sleep apnea/hypopnea syndrome (OSAHS) patients for the prediction of success for uvulopalatopharyngoplasty (UPPP) on the basis of short‐term follow up. The goal of this study is to test the value of this st...
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| Veröffentlicht in: | The Laryngoscope 2004-03, Vol.114 (3), p.454-459 |
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| creator | Friedman, Michael Ibrahim, Hani Joseph, Ninos J. |
| description | Objective Early studies by Friedman et al. have demonstrated the value of staging obstructive sleep apnea/hypopnea syndrome (OSAHS) patients for the prediction of success for uvulopalatopharyngoplasty (UPPP) on the basis of short‐term follow up. The goal of this study is to test the value of this staging system in a prospective study.
Study Design This is a prospective study of two cohorts of patients: one was treated with the benefit of a clinical staging system and the other without.
Methods Patients with symptoms of OSAHS were assessed by polysomnography and were staged according to a previously described staging system. The staging system is based on palate position, tonsil size, and body mass index (BMI). The control group was treated without the benefit of staging. All patients in the control group were treated with UPPP only. Patients in the experimental group were treated based on their clinical stage. Patients with stage I disease, regardless of the severity of disease, were treated with UPPP only. Selected patients with stage II and stage III disease were treated with UPPP in addition to a staged tongue‐base reduction using a radiofrequency technique (TBRF).
Results Follow‐up at 6 months showed significant improvement compared with a group of patients treated without the benefit of a staging system. Successful treatment of patients with stage II disease improved from 37.9% to 74.0%. The overall success rate improved from 40% to 59.1%.
Conclusion Clearly, patients with stage I disease had the best success rate, but a selective protocol based on clinical staging improves the overall success rate. In addition, it can eliminate as surgical candidates those patients with whom the procedure is likely to fail. |
| doi_str_mv | 10.1097/00005537-200403000-00013 |
| format | Article |
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Study Design This is a prospective study of two cohorts of patients: one was treated with the benefit of a clinical staging system and the other without.
Methods Patients with symptoms of OSAHS were assessed by polysomnography and were staged according to a previously described staging system. The staging system is based on palate position, tonsil size, and body mass index (BMI). The control group was treated without the benefit of staging. All patients in the control group were treated with UPPP only. Patients in the experimental group were treated based on their clinical stage. Patients with stage I disease, regardless of the severity of disease, were treated with UPPP only. Selected patients with stage II and stage III disease were treated with UPPP in addition to a staged tongue‐base reduction using a radiofrequency technique (TBRF).
Results Follow‐up at 6 months showed significant improvement compared with a group of patients treated without the benefit of a staging system. Successful treatment of patients with stage II disease improved from 37.9% to 74.0%. The overall success rate improved from 40% to 59.1%.
Conclusion Clearly, patients with stage I disease had the best success rate, but a selective protocol based on clinical staging improves the overall success rate. In addition, it can eliminate as surgical candidates those patients with whom the procedure is likely to fail.</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1097/00005537-200403000-00013</identifier><identifier>PMID: 15091218</identifier><identifier>CODEN: LARYA8</identifier><language>eng</language><publisher>Hoboken, NJ: John Wiley & Sons, Inc</publisher><subject>Adult ; Analysis of Variance ; Biological and medical sciences ; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; obstructive sleep apnea/hypopnea syndrome ; Otorhinolaryngologic Surgical Procedures ; Otorhinolaryngology. Stomatology ; palatal surgery ; Palate - surgery ; Palatine Tonsil - pathology ; Pharynx - surgery ; Pneumology ; Polysomnography ; Prospective Studies ; Respiratory system : syndromes and miscellaneous diseases ; Severity of Illness Index ; Sleep Apnea, Obstructive - diagnosis ; Sleep Apnea, Obstructive - surgery ; Sleep-disordered breathing ; Statistics, Nonparametric ; Treatment Outcome ; Uvula - surgery ; uvulopalatopharyngoplasty</subject><ispartof>The Laryngoscope, 2004-03, Vol.114 (3), p.454-459</ispartof><rights>Copyright © 2004 The Triological Society</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5063-789ed558544e0843b30edad0cbaa7152d9cc5135fb56db4b76a9a2687dcc5db33</citedby><cites>FETCH-LOGICAL-c5063-789ed558544e0843b30edad0cbaa7152d9cc5135fb56db4b76a9a2687dcc5db33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1097%2F00005537-200403000-00013$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1097%2F00005537-200403000-00013$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,1411,23909,23910,25118,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15569512$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15091218$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Friedman, Michael</creatorcontrib><creatorcontrib>Ibrahim, Hani</creatorcontrib><creatorcontrib>Joseph, Ninos J.</creatorcontrib><title>Staging of Obstructive Sleep Apnea/Hypopnea Syndrome: A Guide to Appropriate Treatment</title><title>The Laryngoscope</title><addtitle>The Laryngoscope</addtitle><description>Objective Early studies by Friedman et al. have demonstrated the value of staging obstructive sleep apnea/hypopnea syndrome (OSAHS) patients for the prediction of success for uvulopalatopharyngoplasty (UPPP) on the basis of short‐term follow up. The goal of this study is to test the value of this staging system in a prospective study.
Study Design This is a prospective study of two cohorts of patients: one was treated with the benefit of a clinical staging system and the other without.
Methods Patients with symptoms of OSAHS were assessed by polysomnography and were staged according to a previously described staging system. The staging system is based on palate position, tonsil size, and body mass index (BMI). The control group was treated without the benefit of staging. All patients in the control group were treated with UPPP only. Patients in the experimental group were treated based on their clinical stage. Patients with stage I disease, regardless of the severity of disease, were treated with UPPP only. Selected patients with stage II and stage III disease were treated with UPPP in addition to a staged tongue‐base reduction using a radiofrequency technique (TBRF).
Results Follow‐up at 6 months showed significant improvement compared with a group of patients treated without the benefit of a staging system. Successful treatment of patients with stage II disease improved from 37.9% to 74.0%. The overall success rate improved from 40% to 59.1%.
Conclusion Clearly, patients with stage I disease had the best success rate, but a selective protocol based on clinical staging improves the overall success rate. In addition, it can eliminate as surgical candidates those patients with whom the procedure is likely to fail.</description><subject>Adult</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>obstructive sleep apnea/hypopnea syndrome</subject><subject>Otorhinolaryngologic Surgical Procedures</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>palatal surgery</subject><subject>Palate - surgery</subject><subject>Palatine Tonsil - pathology</subject><subject>Pharynx - surgery</subject><subject>Pneumology</subject><subject>Polysomnography</subject><subject>Prospective Studies</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Severity of Illness Index</subject><subject>Sleep Apnea, Obstructive - diagnosis</subject><subject>Sleep Apnea, Obstructive - surgery</subject><subject>Sleep-disordered breathing</subject><subject>Statistics, Nonparametric</subject><subject>Treatment Outcome</subject><subject>Uvula - surgery</subject><subject>uvulopalatopharyngoplasty</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE9v1DAQxS0EokvhKyBf4BZqx5k45rYqsEWsWml3gXKyHHtSBfIP2wH22-N2l8IRSyN7Rr95fnqEUM5ecabkGUsHQMgsZ6xgInVZKi4ekAUHwbNCKXhIFozlIqsgvz4hT0L4mggpgD0mJxyY4jmvFuTTNpqbdrihY0Ov6hD9bGP7A-m2Q5zochrQnF3sp_H2Qbf7wfmxx9d0SVdz65DGMTGTHyffmoh059HEHof4lDxqTBfw2fE-JR_fvd2dX2Trq9X78-U6s8BKkclKoQOooCiQVYWoBUNnHLO1MZJD7pS1wAU0NZSuLmpZGmXyspIuzV0txCl5edBNHr7PGKLu22Cx68yA4xy05FUBPIcEVgfQ-jEEj41Olnvj95ozfZup_pOpvs9U32WaVp8f_5jrHt3fxWOICXhxBEywpmu8GWwb_uGgVMlE4t4cuJ9th_v_NqDXy80XgILzNL3zkx1k2hDx172M8d90KYUE_flypS838oO63m20Er8BDKmgQQ</recordid><startdate>200403</startdate><enddate>200403</enddate><creator>Friedman, Michael</creator><creator>Ibrahim, Hani</creator><creator>Joseph, Ninos J.</creator><general>John Wiley & Sons, Inc</general><general>Wiley-Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>8BM</scope></search><sort><creationdate>200403</creationdate><title>Staging of Obstructive Sleep Apnea/Hypopnea Syndrome: A Guide to Appropriate Treatment</title><author>Friedman, Michael ; Ibrahim, Hani ; Joseph, Ninos J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5063-789ed558544e0843b30edad0cbaa7152d9cc5135fb56db4b76a9a2687dcc5db33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>obstructive sleep apnea/hypopnea syndrome</topic><topic>Otorhinolaryngologic Surgical Procedures</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>palatal surgery</topic><topic>Palate - surgery</topic><topic>Palatine Tonsil - pathology</topic><topic>Pharynx - surgery</topic><topic>Pneumology</topic><topic>Polysomnography</topic><topic>Prospective Studies</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Severity of Illness Index</topic><topic>Sleep Apnea, Obstructive - diagnosis</topic><topic>Sleep Apnea, Obstructive - surgery</topic><topic>Sleep-disordered breathing</topic><topic>Statistics, Nonparametric</topic><topic>Treatment Outcome</topic><topic>Uvula - surgery</topic><topic>uvulopalatopharyngoplasty</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Friedman, Michael</creatorcontrib><creatorcontrib>Ibrahim, Hani</creatorcontrib><creatorcontrib>Joseph, Ninos J.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>ComDisDome</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Friedman, Michael</au><au>Ibrahim, Hani</au><au>Joseph, Ninos J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Staging of Obstructive Sleep Apnea/Hypopnea Syndrome: A Guide to Appropriate Treatment</atitle><jtitle>The Laryngoscope</jtitle><addtitle>The Laryngoscope</addtitle><date>2004-03</date><risdate>2004</risdate><volume>114</volume><issue>3</issue><spage>454</spage><epage>459</epage><pages>454-459</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><coden>LARYA8</coden><abstract>Objective Early studies by Friedman et al. have demonstrated the value of staging obstructive sleep apnea/hypopnea syndrome (OSAHS) patients for the prediction of success for uvulopalatopharyngoplasty (UPPP) on the basis of short‐term follow up. The goal of this study is to test the value of this staging system in a prospective study.
Study Design This is a prospective study of two cohorts of patients: one was treated with the benefit of a clinical staging system and the other without.
Methods Patients with symptoms of OSAHS were assessed by polysomnography and were staged according to a previously described staging system. The staging system is based on palate position, tonsil size, and body mass index (BMI). The control group was treated without the benefit of staging. All patients in the control group were treated with UPPP only. Patients in the experimental group were treated based on their clinical stage. Patients with stage I disease, regardless of the severity of disease, were treated with UPPP only. Selected patients with stage II and stage III disease were treated with UPPP in addition to a staged tongue‐base reduction using a radiofrequency technique (TBRF).
Results Follow‐up at 6 months showed significant improvement compared with a group of patients treated without the benefit of a staging system. Successful treatment of patients with stage II disease improved from 37.9% to 74.0%. The overall success rate improved from 40% to 59.1%.
Conclusion Clearly, patients with stage I disease had the best success rate, but a selective protocol based on clinical staging improves the overall success rate. In addition, it can eliminate as surgical candidates those patients with whom the procedure is likely to fail.</abstract><cop>Hoboken, NJ</cop><pub>John Wiley & Sons, Inc</pub><pmid>15091218</pmid><doi>10.1097/00005537-200403000-00013</doi><tpages>6</tpages></addata></record> |
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| ispartof | The Laryngoscope, 2004-03, Vol.114 (3), p.454-459 |
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| language | eng |
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| source | Journals@Ovid Ovid Autoload; MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Analysis of Variance Biological and medical sciences Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes Female Humans Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology obstructive sleep apnea/hypopnea syndrome Otorhinolaryngologic Surgical Procedures Otorhinolaryngology. Stomatology palatal surgery Palate - surgery Palatine Tonsil - pathology Pharynx - surgery Pneumology Polysomnography Prospective Studies Respiratory system : syndromes and miscellaneous diseases Severity of Illness Index Sleep Apnea, Obstructive - diagnosis Sleep Apnea, Obstructive - surgery Sleep-disordered breathing Statistics, Nonparametric Treatment Outcome Uvula - surgery uvulopalatopharyngoplasty |
| title | Staging of Obstructive Sleep Apnea/Hypopnea Syndrome: A Guide to Appropriate Treatment |
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