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    Anterior palatoplasty for selected mild and moderate obstructive sleep apnea: preliminary results
    (Springer, 2014) Ugur, Kadriye Serife; Ark, Nebil; Kurtaran, Hanifi; Kizilbulut, Gultekin; Yuksel, Alper; Gunduz, Mehmet
    The aim of this prospective study was to evaluate the long-term efficacy anterior palatoplasty (AP) technique in treatment of patients with mild to moderate obstructive sleep apnea (OSA). Forty-two patients were diagnosed with mild to moderate OSA. Participants were treated with AP for mild or moderate OSA. Patients were evaluated with one night polysomnography before the surgery and 24 months after the surgery. Patients completed Epworth sleepiness scale (ESS), snoring VAS (visual analog scale) before and 24 months after the surgery. Forty two patients with a mean age of 39.2 +/- A 7.6 were included study. Success rate was 57.1 %. Total apnea-hypopnea index (AHI) values significantly decreased after 2 years (p < 0.025). Non-REM AHI and supine AHI values significantly decreased after 2 years (p < 0.025). The oxygen desaturation index changes significantly decreased after AP (p < 0.025). Snoring VAS values significantly decreased after AP (p < 0.025). ESS scores of patients significantly decreased (p < 0.001). We believe that AP is an effective, inexpensive technique for mild and moderate OSA patients.
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    Comparing anterior palatoplasty and modified uvulopalatopharyngoplasty for primarysnoring patients: Preliminary results
    (2013) Uğur, Kadriye Şerife; Kurtaran, Hanifi; Ark, Nebil; Kizilbulut, Gultekin; Yüksel, Alper; Gündüz, Mehmet
    Objectives: To evaluate and compare the long-term efficacy of modified uvulopalatopharyngoplasty (mUP3) and anterior palatoplasty (AP) techniques for treating snoring in a prospective clinical trial. Methodology: Patients with total apnea-hypopnea index values <5/per hour sleep were included in the study. Patients completed the Epworth sleepiness scale (ESS) and snoring visual analogue scale (VAS) before and 24 months after surgery, and a VAS for pain after the operation. Results: Twenty-four patients were in the mUP3 group with a mean age of 42.1 ± 11.8 years, and 26 in AP group with a mean age of 43.2 ± 10.4 years. Snoring VAS values were significantly decreased after surgery in both groups (p<0.025), but changes between operative groups were not statistically significant (p>0.05). Patients' ESS scores in both groups significantly decreased (p<0.025), but ESS score changes between groups were not significantly different (p>0.05). Two years postoperatively, patient satisfaction was 85% in the AP group, and 70% in the mUP3 group. Pain VAS values were significantly lower in the AP group than in the mUP3 group (p<0.001). Eight patients (33.3%) in the mUP3 group and one (7.7%) in the AP group reported nasal regurgitation of liquids upon swallowing during the first week postoperatively. Two years after the operation, 10 patients (41.6%) in the mUP3 group and 9 (34.6%) in AP group still had a lump sensation in the throat. Conclusions: We compared the efficacy of the mUP3 and AP techniques to treat patients with primary snoring and found less morbidity and more patient satisfaction in the AP group. © 2014 Elsevier B.V., All rights reserved.
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    Long-term results of one staged multilevel surgery with tongue suspension surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea
    (Springer, 2016) Yuksel, Alper; Ugur, Kadriye Serife; Kizilbulut, Gultekin; Ark, Nebil; Kurtaran, Hanifi; Kaya, Mesut; Gunduz, Mehmet
    The objective of this study is to evaluate and compare the long-term efficacy of the one staged multilevel surgery (MLS) with tongue suspension (TBS) surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea (OSA). This is a prospective cross-sectional study. Setting: University hospital. Thirty-three patients diagnosed as moderate to severe OSA. Patients, with a parts per thousand yen50 % retropalopharyngeal obstruction on the Muller maneuver, were treated with palatal surgeries (PS) and patients, with a parts per thousand yen50 % retropalopharyngeal obstruction on the Muller maneuver with a parts per thousand yen50 % base of the tongue collapse, were treated with palatal surgeries and tongue suspension surgery (TBS). Patients were evaluated with one night polysomnography before the surgery and 24 months after the surgery. Patients completed Epworth sleepiness scale (ESS), snoring VAS (visual analog scale) before and 24 months after the surgery. Nine-teen patients with a mean age of 46.1 +/- A 8.3 underwent palatal surgeries (PS) and 14 patients with a mean age of 41.4 +/- A 8.9 underwent PS plus TBS. Success rate in TBS+PS group was 57.1 % and in PS group was 42.1 %. In both groups total apnea-hypopnea index (AHI) values significantly decreased after 2 years (p < 0.025) but there was no statistically significant difference between TBS+PS and PS groups. Supine AHI levels were reduced statistically significant in both groups postoperatively (p < 0.025). There was not any significant difference postoperatively in non-supine AHI levels in both groups (p > 0.025). There were significant postoperative changes in ODI, AVO2, MOS, ESS, Snoring VAS values in PS group (p < 0.025). In TBS+PS group there was a significant difference postoperatively only in ODI values. Treatment of OSA patients with retropalatal or retropalatal and retroglossal obstruction, in a one staged surgery, is a safe and easy procedure. We have achieved favorable long-term outcomes in moderate-severe OSA patients undergoing both palatal surgery and tongue suspension surgery.