Effects and side-effects of surgery for snoring and obstructive sleep apnea--a systematic review

2.50
Hdl Handle:
http://hdl.handle.net/2336/83510
Title:
Effects and side-effects of surgery for snoring and obstructive sleep apnea--a systematic review
Authors:
Franklin, Karl A; Anttila, Heidi; Axelsson, Susanna; Gislason, Thorarinn; Maasilta, Paula; Myhre, Kurt I; Rehnqvist, Nina
Citation:
Sleep. 2009, 32(1):27-36
Issue Date:
1-Jan-2009
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.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2625321&blobtype=pdf

Full metadata record

DC FieldValue Language
dc.contributor.authorFranklin, Karl Aen
dc.contributor.authorAnttila, Heidien
dc.contributor.authorAxelsson, Susannaen
dc.contributor.authorGislason, Thorarinnen
dc.contributor.authorMaasilta, Paulaen
dc.contributor.authorMyhre, Kurt Ien
dc.contributor.authorRehnqvist, Ninaen
dc.date.accessioned2009-10-05T13:33:26Z-
dc.date.available2009-10-05T13:33:26Z-
dc.date.issued2009-01-01-
dc.date.submitted2009-09-05-
dc.identifier.citationSleep. 2009, 32(1):27-36en
dc.identifier.issn0161-8105-
dc.identifier.pmid19189776-
dc.identifier.urihttp://hdl.handle.net/2336/83510-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractSTUDY 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.en
dc.language.isoenen
dc.publisherAsoociated Professional Sleep Societiesen
dc.relation.urlhttp://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2625321&blobtype=pdfen
dc.subject.meshAdulten
dc.subject.meshDisorders of Excessive Somnolenceen
dc.subject.meshElectrosurgeryen
dc.subject.meshHumansen
dc.subject.meshLaser Therapyen
dc.subject.meshPalate, Soften
dc.subject.meshPharynxen
dc.subject.meshPostoperative Complicationsen
dc.subject.meshQuality of Lifeen
dc.subject.meshRandomized Controlled Trials as Topicen
dc.subject.meshSleep Apnea, Obstructiveen
dc.subject.meshSnoringen
dc.subject.meshTreatment Outcomeen
dc.subject.meshUvulaen
dc.titleEffects and side-effects of surgery for snoring and obstructive sleep apnea--a systematic reviewen
dc.typeArticleen
dc.contributor.departmentSwedish Council on Technology Assessment in Health Care, Stockholm, Sweden. Karl.Franklin@lung.umu.seen
dc.identifier.journalSleepen

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