Alternatives to Positive Pressure: Surgical Therapy

Kribbs NB , Pack AI , Kline LR , Smith PL , Schwartz AD , Schubert NM , et al. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis 1993;147(4):887–895.

Reeves-Hoche MK , Hudgel DW , Meck R , Witteman R , Ross A , Zwillich CW . Continuous versus bilevel positive airway pressure for obstructive sleep apnea. J Respir Crit Care Med 1995;151(2 Pt 1):443–449.

Fletcher EC , Luckett RA . The effect of positive reinforcement on hourly compliance in nasal continuous positive airway pressure users with obstructive sleep apnea. Am Rev Respir Dis 1991;143(2):936–941.

Likar LL , Panciera TM , Erickson AD , Rounds S. Group education sessions and compliance nasal CPAP therapy, Chest 1997;111(5):1273–1277.

Isono S , Remmers JE , Tanaka A , Sho Y , Sato J , Nishino T. Anatomy of the pharynx in patients with obstructive sleep apnea and in normal subjects. J Appl Physiol 1997;82(4):1319–1326.

Haponik EF , Smith PL , Bohlman ME , Allen RP , Goldman SM , Bleecker ER , et al. Computerized tomography in obstructive sleep apnea: correlation of airway size with physiology during sleep and wakefulness. Am Rev Respir Dis 1983;127(2):221–226.

Galvin JR , Rooholamini SA , Standford W. Obstructive sleep apnea: diagnosis with ultrafast CT. Radiology 1989;171(3):775–778.

Gleadhill IC , Schwartz AR , Schubert N , Wise RA , Permutt S , Smith PL . Upper airway collapsibility in snorers and in patients with obstructive sleep apnea Am Rev Respir Dis 1991;143(6):1300–1303.

Bradley TD , Brown IG , Grossman RF , Zamel N , Martinez D , Phillipson EA , et al. Pharyngeal size in snorers, nonsnorers, and patients with obstructive sleep apnea. N Engl J Med 1986;315(21):1327–1331.

Ryan CF , Love LL . Mechanical properties of the velopharynx in obese patients with obstructive sleep apnea. Am J Respir Crit Care Med 1996;154(3 Pt 1):806–812.

Gold AR , Schwartz AR . The pharyngeal critical pressure, the whys and hows of using nasal continuous positive airway pressure diagnostically. Chest 1996;110(4):1077–1088.

Isono S , Remmers JE . Anatomy and physiology of upper airway obstruction. In: Kryger MH , Roth T , Dement WC (editors). Principles and practice of sleep medicine. 2nd ed. Philadelphia: WB Saunders, 1994.

Laitman JT , Reidenberg JS . Specializations of the human upper respiratory and upper digestive systems as seen through comparative and developmental anatomy. Dysphagia 1993;8(4):318–325.

Lyberg T , Krogstad O , Djupesland G. Cephalometric analysis in patients with obstructive sleep apnea syndrome: skeletal morphology. J Laryngol Otol 1989;103(3):287–292.

Kuna ST , Bedi DG , Ryckman C. Effect of nasal airway positive pressure on upper airway size and configuration. Am Rev Respir Dis 1988;138(4):969–975.

Rojewski TE , Schuller DE , Clark RW , Schmidt HS , Potts RE . Video-endoscopic determination of the mechanism of obstruction in obstructive sleep apnea Otolaryngol Head Neck Surg 1984;92(2):127–131.

Lyberg T , Krogstad O , Djupesland G. Cephalometric analysis in patients with obstructive sleep apnoea syndrome: soft tissue morphology. J Laryngol Otol 1989;103(3):293–297.

Lowe AA , Ozbek MM , Miyamoto K , Pack AI , Fleetham JA . Cephalometric and demographic characteristics of obstructive sleep apnea: an evaluation with partial least squares analysis. Angle Orthodontist 1997;67(2):143–153.

Morrison DL , Launois SH , Isono S , Feroah TR , Whitelaw WA , Semmers SE . Pharyngeal narrowing and closing pressures in patients with obstructive sleep apnea. Am Rev Respir Dis 1993;148(3):606–611.

Skatvedt O. Continuous pressure measurements in the pharynx and esophagus during sleep in patients with obstructive sleep apnea syndrome. Laryngoscope 1992;102(11):1275–1280.

Katsantonis GP , Moss K , Miyazaki Swalsh J . Determining the site of airway collapse in obstructive sleep apnea with airway pressure monitoring. Laryngoscope 1993;103(10):1126–1131.

Rodenstein DO , Dooms G , Thomas Y , Liistro G , Stanescu DC , Culee C , Aubert-Tulkens G. Pharyngeal shape and dimensions in healthy subjects, snorers, and patients with obstructive sleep apnoea. Thorax 1990;45(10):723–727.

Schwab RJ , Gupta KB , Gefter WB , Metzger LJ , Hoffman EA , Pack Al . Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing: significance of the lateral pharyngeal walls. Am J Respir Crit Care Med 1995;152(5 Pt 2):1673–1689.

Sher AE , Schechtman KB , Piccirillo JF . The efficacy of surgical modifications for the upper airway in adults with obstructive sleep apnea syndrome. Sleep 1996;19(2):156–177.

Aboussouan LS , Golish JA , Wood BG , Mehta AC , Wood DE , Dinner DS . Dynamic pharyngoscopy in predicting outcome of uvulopalatopharyngoplasty for moderate and severe obstructive sleep apnea. Chest 1995;107(4):946–951.

Janson C , Gislason T , Bengtsson H , Eriksson G , Lindberg E , Lindholm C , et al. Long-term follow-up of patients with obstructive sleep apnea treated with uvulopalatopharyngoplasty. Arch Otolaryngol Head Neck Surg 1997;123(3):257–262.

Pringle MG , Croft CB . A comparison of sleep nasendoscopy and the Müller maneuver. Clin Otolaryngol 1991;16(6):559–562.

Skatvedt O. Localization of site of obstruction in snorers and patients with obstructive sleep apnea syndrome: a comparison of fiberoptic nasopharyngoscopy and pressure measurements. Acta Otolaryngology (Stockholm) 1993;113(2):206–209.

Martin SE , Wraith PK , Deary IJ , Douglas NJ . The effect of nonvisible sleep fragmentation on daytime function. Am Rev Respir Crit Care Med 1997;155(5):1596–1601.

Zorick FJ , Roehrs T , Conway W , Potts G , Roth T. Response to CPAP and UPPP in apnea. Henry Ford Hosp Med J 1990;38(4):223–226.

He J , Kryger MH , Zorick FJ , Conway W , Roth T. Mortality and apnea index in obstructive sleep apnea: experience in 385 male patients. Chest 1988;94(1):9–14.

Lavie P , Herer P , Pedled R , Berger N , Toffe N , Zomer J , Rubin AH . Mortality in sleep apnea patients: a multivariate analysis of risk factors. Sleep 1995;18(3):149–157.

Keenan SP , Burt H , Ryan CF , Fleetham JA . Long-term survival of patients with obstructive sleep apnea treated by uvulopalatopharyngoplasty or nasal CPAP. Chest 1994;105(1):155–159.

Findley LJ , Levinson MP , Bonnie RJ . Driving performance and automobile accidents in patients with sleep apnea. Clin Chest Med 1992;13(3):427–435.

Haraldsson PO , Carenfelt C , Lysdahl M , Tornros J. Long-term effect of uvulopalatopharyngoplasty on driving performance. Arch Otolaryngol Head Neck Surg 1995;121(1):90–94.

Haraldsson PO , Carenfelt C , Lysdahl M , Tingvall C. Does uvulopalatopharyngoplasty inhibit automobile accidents? Laryngoscope 1995;105(6):657–661.

Schwartz AR , Schubert N , Rothman W , Godley F , Marsh B , Eisele D , et al. Effect of uvulopalatopharyngoplasty on upper airway collapsibility in obstructive sleep apnea. Am Rev Respir Dis 1992;145(3):527–532.

Wright S , Haight J , Zamel N , Hoffstein V. Changes in pharyngeal properties after uvulopalatopharyngoplasty. Laryngoscope 1989;99(1):62–65.

Series F , St Pierre S , Carrier G. Surgical correction of nasal obstruction in the treatment of mild sleep apnoea: importance of cephalometry in predicting outcome. Thorax 1993;48(4):360–363.

Launois SH , Feroah TR , Campbell WN , Issa FG , Morrison D , Whitelaw WA , et al. Site of pharyngeal narrowing predicts outcome of surgery for obstructive sleep apnea. Am Rev Respir Dis 1993;147(1):182–189.

Huang L. Mechanical modeling of palatal snoring. J Acoust Soc Am 1995;97(6):3642–3648.

Liistro G , Stanescu DC , Rodenstein DO , Aubert-Tulkens G. Pattern of snoring in obstructive sleep apnea patients and heavy snorers. Sleep 1991;14(6):517–525.

Walker RP , Gatti WM , Poirier N , Davis JS . Objective assessment of snoring before and after laser-assisted uvulopalatoplasty. Laryngoscope 1996;106(11):1372–1377.

Fujita S , Conway WA , Zorick FJ , Sicklesteel JM , Roehrs TA , Wittig RM , Roth T. Evaluation of the effectiveness of the uvulopalatopharyngoplasty. Laryngoscope 1985;95(1):70–74.

Friberg D , Carlson-Norlander B , Larsson H , Svanborg E. UPPP for habitual snoring: a 5 year follow-up with respiratory sleep recordings. Laryngoscope 1995;105(5 Pt 1):519–522.

Larsson H , Carlsson-Nordlander B , Svanborg E. Long-time follow-up after UPPP for obstructive sleep apnea syndrome. Acta Otolaryngol (Stockholm) 1991;111:582–590.

Boudewyns A , De Cock W , Willemen M , Wagemans M , De Backer W , Van de Heyning PH . Influence of uvulopalatopharyngoplasty on alpha EEG arousals in nonapnoeic snorers. Eur Respir J 1997;10(1):129–132.

Finkelstein Y , Talmi YP , Raveh E , Orlin J , Rudnicki C , Fried M , Zahavi Y. Can obstructive sleep apnea be a complication of uvulopalatopharyngoplasty? J Laryngol Otol 1995;109(3):212–217.

Mortimore IL , Bradley PA , Murray AM , Douglas NJ . Uvulopalatopharyngoplasty may compromise nasal CPAP therapy in the obstructive sleep apnea syndrome Am J Respir Crit Care Med 1996;154(6 Pt 1):1759–1762.

Ryan CF , Dickson RI , Lowe AA , Blokmanis A , Fleetham JA . Upper airway measurements predict response to uvulopalatopharyngoplasty in obstructive sleep apnea. Laryngoscope 1990;100(3):248–253.

Riley R , Guilleminault C , Powell N , Simmons FB . Palatopharyngoplasty failure: cephalometric roentgenograms, and obstructive sleep apnea. Otolaryngol Head Neck Surg 1985;93(2):240–244.

Guilleminault C , Riley R , Powell N. Obstructive sleep apnea and abnormal cephalometric measurements: implications for treatment. Chest 1984;86(5):793–794.

Petri N , Suadicani P , Wildschiodtz G , Bjorn-Jorgensen J. Predictive value of Müller maneuver, cephalometry and clinical features for the outcome of uvulopalatopharyngoplasty: evaluation of predictive factors using discriminant analysis in 30 sleep apnea patients. Acta Otolaryngol (Stock) 1994;114(5):565–571.

Doghramji K , Jabourian ZH , Pilla M , Farole A , Lindholm RN . Predictors of outcome for uvulopalatopharyngoplasty. Laryngoscope 1995;105(3 Pt 1):311–314.

Woodson BT , Conley SF , Dohse A , Feroah TR , Sewall SR , Fujita S. Posterior cephalometric radiographic analysis in obstructive sleep apnea. Ann Oto Rhinol Laryngol 1997;106(4):310–313.

Woodson BT , Conley SF . Prediction of uvulopalatopharyngoplasty response using cephalometric radiographs. Am J Otolaryngol 1997;18(3):179–184.

Kamami YV . Outpatient treatment of sleep apnea syndrome with CO2 laser: laser-assisted UPPP results on 46 patients. J Otolaryngol 1994;23(6):395–398.

Walker RP , Grigg-Damberger MM , Gopalsami MC , Totten MC . Laser-assisted uvulopalatoplasty for snoring and obstructive sleep apnea: results in 170 patients. Laryngoscope 1995;105(9 Pt 1):938–943.

Mickelson SA . Laser-assisted uvulopalatoplasty for obstructive sleep apnea. Laryngoscope 1996;106(1 Pt 1):10–13.

Walker RP , Grigg-Damberger MM , Gopalsami C. Uvulopalatopharyngoplasty versus laser-assisted uvulopalatoplasty for the treatment of obstructive sleep apnea. Laryngoscope 1997;107(1):76–82.

Finkelstein Y , Shapiro-Feinberg M , Stein G , Ophir D. Uvulopalatopharyngoplasty vs laser-assisted uvulopalatoplasty: anatomical considerations. Arch Otolaryngol Head Neck Surg 1997;12(3):265–276.

Walker RP , Grigg-Damberger MM , Gopalsami MC . Laser-assisted uvulopalatoplasty for the treatment of mild, moderate, and severe obstructive sleep apnea. Otolaryngol Head Neck Surg 1997;107:116S.

Utley DS , Shin EJ , Clerk AA , Terris DJ . A cost-effective and rational surgical approach to patients with snoring, upper airway resistance syndrome, or obstructive sleep apnea syndrome. Laryngoscope 1997;107(6):726–734.

Skadtvedt O , Akre H , Godtlibsen OB . Continuous pressure measurements in the evaluation of patients for laser-assisted uvulopalatoplasty. Eur Arch Otorhinolaryngol 1996;253(7):390–394.

Terris DJ , Clerk AA , Norbash AM , Troell RJ . Characterization of postoperative edema following laser-assisted uvulopalatoplasty using MRI and polysomnography: implications for the outpatient treatment of obstructive sleep apnea syndrome. Laryngoscope 1996;106(2 Pt 1):124–128.

Isono S , Tanaka A , Sho Y , Konno A , Nishino T. Advancement of the mandible improves velopharyngeal airway patency. J Appl Physiol 1995;79(6):2132–2138.

Riley RW , Powell NB , Guilleminault C. Maxillofacial surgery and obstructive sleep apnea: a review of 80 patients. Otolaryngol Head Neck Surg 1989;101(3):353–361.

Mintz SM , Ettinger AC , Geist J , Geist JR . A modified geniotomy technique for obstructive sleep apnea syndrome. J Oral Maxillofac Surg 1995;53(10):1225–1228.

Riley RW , Powell NB , Guilleminault C. Obstructive sleep apnea and the hyoid: a revised surgical procedure. Otolaryngol Head Neck Surg 1994;111(6):717–721.

Riley RW , Powell NB , Guilleminault C. Obstructive sleep apnea syndrome: a review of 306 consecutively treated surgical patients. Otolaryngol Head Neck Surg 1993;108(2):117–125.

Johnson NT , Chinn J. Uvulopalatopharyngoplasty and inferior sagittal mandibular osteotomy with genioglossus advancement for treatment of obstructive sleep apnea. Chest 1994;105(1):155–159.

Lojander J , Maasilta P , Partinen M , Brander P , Salmi T , Lehtonen H. Nasal-CPAP, surgery, and conservative management for treatment of obstructive sleep apnea syndrome. Chest 1996;110(1):114–119.

Waite PD , Wooten V , Lachner J , Guyette RF. Maxillornandibular advancement surgery in 23 patients with obstructive sleep apnea syndrome. J Oral Maxillofac Surg 1989;47(12):1256–1261.

Hochban W , Brandenburg U , Peter JH. Surgical treatment of obstructive sleep apnea by maxillomandibular advancement. Sleep 1994; 17(7):624–629.

Fujita S , Woodson BT , Clark JL , Wittig R. Laser midline glossectomy as a treatment for obstructive sleep apnea. Laryngoscope 1991;101(8):805–809.

Mickelson SA , Rosenthal L. Midline glossectomy and epiglottidectomy for obstructive sleep apnea syndrome. Laryngoscope 1997;107(5):614–619.

Woodson BT , Fujita S. Clinical experience with lingulaplasty as part of the treatment of severe obstructive sleep apnea. Otolaryngol Head Neck Surg 1992;107(1):40–48.

Powell N , Riley R. New technology for snoring and obstructive sleep apnea: radiofreguency volumetric tissue reduction of the palate (abstract). Otolaryngol Head Neck Surg 1997;107: 112.

Schwartz AR , Eisele DW , Hari A , Testerman R , Erickson D , Smith PL. Electrical stimulation of the lingual musculature in obstructive sleep apnea. J Appl Physiol 1996;81(2):643–652.

Faye-Lund H , Djupesland G , Lyberg T. Glossopexia: evaluation of a new surgical method for treating obstructive sleep apnea syndrome. Acta Otolaryngol (Stockh) 1992;492(Suppl):46–49.

Powell NB. Riley RW. Guilleminault C. Murcia GN. Obstructive sleep apnea, continuous positive airway pressure, and surgery. Otolaryngol Head & Neck Surg 1988;99(4):362–369.