Predictors of uvulopalatopharyngoplasty outcomes in patients with supine predominant positional obstructive sleep apnea: a prospective observational study

Background: It is uncertain which factors substantially influence outcomes after uvulopalatopharyngoplasty (UPPP) in patients with supine predominant obstructive sleep apnea (POSA) Objective: To explore the predictors of UPPP outcomes in POSA patients. Methods: A total of 108 patient(52 positional patients (POSA) and 56 nonpositional patients(NPP)), who underwent the revised uvulopalatopharyngoplasty (H-UPPP), were retrospectively studied. The pre-operative information of these patients, including polysomnography (PSG), and upper airway CT, were collected for analysis. Results: No difference was found in surgical success rates between POSA and NPP undergoing H-UPPP. In POSA patients, there were statistically significant differences between responders and nonresponders in body mass index (BMI), preoperative supine AHI, time of SaO2 < 90% ( TS 90) (all p <.05), minimal anteroposterior airway (mAP) (p =.016), minimal lateral airway (mLAT) (p =.002), minimal cross-sectional airway area (mCSA) (p <.001) at the velopharynx. mLAT (p =.014) and mCSA (p =.002) at the glossopharynx. The independent associated factors for surgical success were lower BMI (p <.001), narrowerm LAT (p =.002) and mAP (p <.001) at velopharynx, and wider mCSA (p <.001) at glossopharynx in POSA. Conclusion: POSA patients with lower BMI, narrower mLAT and mAP at velopharynx, wider mCSA at glossopharynx were more likely to achieve a positive outcome with H-UPPP.