One-phase management of severe obstructive sleep apnea: Tongue base reduction with hyoepiglottoplasty plus uvulopalatopharyngoplasty

Objectives: To describe the results of a 1 phase surgical procedure for the treatment of severe obstructive sleep apnea (OSA) attributable to tongue base obstruction. Study design and setting: A retrospective nonrandomized study at S Orsola Malpighi University Hospital of Bologna, Italy. Methods: Ten male patients affected by severe OSA (mean apnea/hypopnea index [AHI] of 54.7), underwent uvulopalatopharyngoplasty (UPPP) associated with tongue base reduction and hyoepiglottoplasty (TBRHE). The indications to this surgical procedure were based on the presence of hyolingual abnormalities and absence of craniofacial deficiencies determined by preoperative assessment. Results: Mean AHI decreased from 54.7 ± 11.5 to 9.4 ± 5.4 whereas the mean low SaO2 value went from 77% ± 6.2 to 90.7% ± 3 and the time of sleep with SaO2 < 90% improved from 53% ± 17.2 to 7.3% ± 8. The overall success rate was 100%. Conclusions and significance: TBRHE is an effective and safe treatment in patients with severe OSA attributable to tongue base obstruction and in absence of craniofacial deficiencies. © 2006 American Academy of Otolaryngology-Head and Neck Surgery Foundation.