Harmonic Scalpel Assisted Uvalopalatopharyngoplasty

Yanpeng  Hou; Zhenming  Xu; Xiaofeng  Cui; Yin  Guo

doi:10.4236/ijohns.2016.52017

Yanpeng Hou, Zhenming Xu, Xiaofeng Cui, Yin Guo

Abstract: Objectives: To investigate the evaluation of the harmonic scalpel-assisted uvulopalatopharyn-goplasty (UPPP) surgery with posterior wall of uvula mucosa sutured with anterior wall. Design: According to the diagnostic criteria published by Chinese medical association of otolaryngology-head and neck, 21 cases were performed UPPP with the harmonic scalpel. The Regional Ethics Committee of our hospital approved the study protocol. Informed written consent was obtained from all participants. Setting: A single specialist hospital. Participants: 21 patients with OSAHS. Participants were not randomized in groups and were performed UPPP with the harmonic scalpel. Main Outcome Measures: Part of the uvula muscle and the anterior wall of the uvula mucosa were removed, and the mucosa of posterior wall was preserved. The mucosa of the posterior wall was sutured with the remaining part of the anterior wall. The AHI and LaSO₂ were measured both before and six months after the operation by Polysomnography (PSG). Results: This study reported a significant improvement (p < 0.01) at six months of follow-up. The effective rate of this surgery was 76.2% at six month. Preoperative AHI (

± s) was 48.6 ± 12.65, and LSaO₂ (

± s) was 67.4% ± 9.18%; postoperative AHI was 10.9 ± 9.29, and postoperative LSaO₂ was 91.0 ± 1.47. The mean operation duration was 30.1 minutes. Conclusion: The use of HS in UPPP is efficient and shows some advantages over conventional method: its use provided a blood free surgery field, and shorter operation duration.

Keywords: Sleep Apnea-Hyperpnoea Syndrome, Uvulopalatopharyngoplasty (UPPP), Harmonic Scalpel, Bleeding

Cite this paper: Hou, Y. , Xu, Z. , Cui, X. and Guo, Y. (2016) Harmonic Scalpel Assisted Uvalopalatopharyngoplasty. International Journal of Otolaryngology and Head & Neck Surgery, 5, 103-107. doi: 10.4236/ijohns.2016.52017.

References

[1] Mylavarapu, G., Murugappan, S., Mihaescu, M., Kalra, M., Khosla, S. and Gutmark, E. (2009) Validation of Computational Fluid Dynamics Methodology Used for Human Upper Airway Flow Simulations. Journal of Biomechanics, 42, 1553-1559.
http://dx.doi.org/10.1016/j.jbiomech.2009.03.035

[2] Ayappa, I. and Rapoport, D.M. (2003) The Upper Airway in Sleep: Physiology of the Pharynx. Sleep Medicine Review, 7, 9-33.
http://dx.doi.org/10.1053/smrv.2002.0238

[3] Vgontzas, A.N., Bixler, E.O. and Chrousos, G.P. (2005) Sleep Apnea Is a Manifestation of the Metabolic Syndrome. Sleep Medicine Review, 9, 211-224.
http://dx.doi.org/10.1016/j.smrv.2005.01.006

[4] Young, T., Peppard, P.E. and Gottlieb, D.J. (2002) Epidemiology of Obstructive Sleep Apnea: A Population Health Perspective. Am J Respir Crit Care Med, 165, 1217-1239.
http://dx.doi.org/10.1164/rccm.2109080

[5] Kandasamy, T., et al. (2013) The Incidence of Early Postoperative Complications Following Uvulopalatopharyngoplasty: Identification of Predictive Risk Factors. Journal of Otolaryngology—Head and Neck Surgery, 42, 15.

[6] Friedman, M., Vidyasagar, R., Bliznikas, D., et al. (2006) Patients Selection and Efficacy of Pillar Implant Technique for Treatment of Snoring and Obstructive Sleep Apnea/Hypopnea Syndrome. Otolaryngology—Head and Neck Surgery, 134, 187-196.
http://dx.doi.org/10.1016/j.otohns.2005.10.032

[7] Friedman, M., Ibrahim, H. and Bass, L. (2002) Clinical Staging for Sleep-Disordered Breathing. Otolaryngology— Head and Neck Surgery, 127, 13-21.
http://dx.doi.org/10.1067/mhn.2002.126477

[8] Konstantinos, K., Athanasios, S.K., Panagiotis, G.D., et al. (2007) The Use of a Harmonic Scalpel in Thyroid Surgery: A Report of a 3-Year Experience. The American Journal of Surgery, 193, 693-696.
http://dx.doi.org/10.1016/j.amjsurg.2006.06.049

[9] Salami, A., Dellepiane, M., Bavazzano, M., et al. (2008) New Trends in Head and Neck Surgery: A Prospective Evaluation of the Harmonic Scalpel. Medical Science Monitor, 14, 1-5.

[10] Sinha, U.K. and Gallagher, L.A. (2003) Effects of Steel Scalpel, Ultrasonic Scalpel, CO2 Laser, and Monopolar and Bipolar Electrosurgery on Wound Healing in Guinea Pig Oral Mucosa. Laryngoscope, 11, 228-236.
http://dx.doi.org/10.1097/00005537-200302000-00007

[11] Salami, A., Dellepiane, M., Bavazzano, M., et al. (2010) Harmonic Scalpel vs “Cold Knife” Dissection in Uvulopalatopharyngoplasty. American Journal of Otolaryngology, 31, 442-447.
http://dx.doi.org/10.1016/j.amjoto.2009.08.009

[12] Back, G.W., Nadig, S., Uppal, S., et al. (2004) Why Do We Have a Uvula? Literature Review and a New Theory. Clinical Otolaryngology & Allied Sciences, 29, 689-693.
http://dx.doi.org/10.1111/j.1365-2273.2004.00886.x