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Cited by 182Obstructive Sleep Apnea ResearchNasal Surgery and Airway StudiesSleep and related disorders

Effects and Side-Effects of Surgery for Snoring and Obstructive Sleep Apnea — A Systematic Review

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Karl A. Franklin, Heidi Anttila, Susanna Axelsson, Þórarinn Gíslason, Paula K Maasilta, Kurt I. Myhre, Nina Rehnqvist·2009·Sleep
DOI 10.5665/sleep/32.1.27PMC PMC2625321
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Abstract

STUDY OBJECTIVES: Many patients undergo surgery for snoring and sleep apnea, although the efficacy and safety of such procedures have not been clearly established. Our aim was systematically to review studies of the efficacy and adverse effects of surgery for snoring and obstructive sleep apnea. DESIGN: Systematic review. MEASUREMENTS: PubMed and Cochrane databases were searched in September 2007. Randomized controlled trials of surgery vs. sham surgery or conservative treatment in adults, with daytime sleepiness, quality of life, apnea-hypopnea index, and snoring as outcomes were included. Observational studies were also reviewed to assess adverse effects. Evidence of effect required at least two studies of medium and high quality reporting the same result. RESULTS: Four studies of benefits and 45 studies of adverse effects were included. There was no significant effect on daytime sleepiness and quality of life after laser-assisted uvulopalatoplasty and radiofrequency ablation. The apnea-hypopnea index and snoring was reduced in one trial after laser-assisted uvulopalatoplasty but not in another trial. Subjective snoring was reduced in one trial after radiofrequency ablation. No trial investigating the effect of any other surgical modality met the inclusion criteria. Persistent side-effects occurred after uvulopalatopharyngoplasty and uvulopalatoplasty in about half the patients and difficulty in swallowing, globus sensation and voice changes were especially common. CONCLUSIONS: Only a small number of randomized controlled trials with a limited number of patients assessing some surgical modalities for snoring or sleep apnea are available. These studies do not provide any evidence of effect from laser-assisted uvulopalatoplasty or radiofrequency ablation on daytime sleepiness, apnea reduction, quality of life or snoring. We call for research of randomized, controlled trials of surgery other than uvulopalatopharyngoplasty and uvulopalatoplasty, as they are related to a high risk of long-term side-effects, especially difficulty swallowing.

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  • Long-term side-effects (e.g. swallowing, globus sensation, voice changes or nasopharyngeal stenosis) persisted after UPPP in 58% of the patients.

    “Long-term side-effects (e.g. swallowing, globus sensation, voice changes or nasopharyngeal stenosis) persisted after UPPP in 58% of the patients 211.”

    From Non-CPAP therapies in obstructive sleep apnoea (2011) · cites this paper as [211]

    The Results section and Table 4 report persistent side-effects after UPPP in a mean of 58% of patients, with limited evidence, and identify swallowing difficulties, voice changes, and globus sensation. Nasopharyngeal stenosis appears in a cited reference title, but the review does not identify it as one of the side-effects included in the 58% estimate. (LLM, conf=0.83)

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Cited by

Sorted by citations

Authors
Franklin, K. A., Anttila, H., Axelsson, S., Gíslason, Þ., Maasilta, P. K., Myhre, K. I., & Rehnqvist, N.
Affiliations
  • Danderyds sjukhus (SE)
  • Finnish Institute for Health and Welfare (FI)
  • SBU - Swedish Agency for Health Technology Assessment and Assessment of Social Services (SE)
  • National University Hospital of Iceland (IS)
  • Helsinki University Hospital (FI)
  • Karolinska Institutet (SE)
Corresponding author
Karl A. Franklin
ORCID
Venue
Sleep
Publisher
Oxford University Press (OUP)
Published
2009-01-01
Volume
32
Issue
1
Pages
27-36
ISSN
  • 0161-8105 (ISSN-L)
  • 1550-9109
DOI
10.5665/sleep/32.1.27
PMC
PMC2625321
OpenAlex
W4313369815
Cited by
182
References
2
Citations by year
2025: 4 · 2024: 7 · 2023: 5 · 2022: 10 · 2021: 11 · 2020: 5 · 2019: 9 · 2018: 11 · 2017: 13 · 2016: 14 · 2015: 14 · 2014: 9 · 2013: 18 · 2012: 15
FWCI
11.08
Type
journal article
Language
en
Open access
Locations
  • SLEEP (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Hirsla (Landspítali University Hospital) (submittedVersion)
  • PubMed
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
snoring, obstructive sleep apnea, sleep apnea surgery, laser-assisted uvulopalatoplasty, radiofrequency ablation, uvulopalatopharyngoplasty, uvulopalatoplasty, daytime sleepiness, quality of life, apnea-hypopnea index, surgical side effects, dysphagia, globus sensation, voice change
MeSH terms
Adult, Electrosurgery, Humans, Disorders of Excessive Somnolence, Palate, Soft, Pharynx, Postoperative Complications, Quality of Life, Snoring, Uvula, Randomized Controlled Trials as Topic, Treatment Outcome, Sleep Apnea, Obstructive, Laser Therapy

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