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Assessment of obstruction level and selection of patients for obstructive sleep apnoea surgery: an evidence-based approach

Published online by Cambridge University Press:  11 August 2009

C Georgalas ,
G Garas ,
E Hadjihannas  and
A Oostra
C Georgalas
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Academic Medical Centre, Amsterdam, The Netherlands
G Garas*
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, St Mary's Hospital, London, UK
E Hadjihannas
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital, Birmingham, UK
A Oostra
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Academic Medical Centre, Amsterdam, The Netherlands
*
Address for correspondence: Dr George Garas, Flat 3C, 96 Sutherland Avenue, London W9 2QR, UK. Fax: +44 207 286 9016 E-mail: garas_george@yahoo.com
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Abstract

Introduction:

Obstructive sleep apnoea has long been recognised as a clinical syndrome; however, high quality evidence on the effects of surgery for this condition is still missing. Despite this, a consensus seems to be evolving, albeit based on limited evidence, that surgery should be offered as a second line treatment to suitable patients with obstructive sleep apnoea.

Aims:

This article aims to assess the different methods of investigating upper airway obstruction in patients with obstructive sleep apnoea, in respect to these methods' relevance to surgical treatment, via a systematic review of the literature.

Methods:

The Cochrane Controlled Trials Register, Medline and EMBASE were searched from 1966 onwards. The search was performed in August 2008. A total of 2001 citations were retrieved.

Results and conclusion:

There is not yet a generally accepted way to assess surgical candidacy based on the level of obstruction. Better organised clinical studies with well defined endpoints are needed. In the meanwhile, it appears that sleep nasendoscopy, acoustic reflectometry and pressure catheters can all provide useful information, and their use may be decided upon based on the experience and resources available in individual departments.

Keywords

Obstructive Sleep Apnea SyndromeCephalometryPolysomnographyFluoroscopyComputerised TomographyMagnetic Resonance ImagingPressureAcousticsEndoscopyLasers
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 1 , January 2010 , pp. 1 - 9
Copyright
Copyright © JLO (1984) Limited 2009

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