Systematic review and updated meta-analysis of multi-level surgery for patients with OSA

Authors

Yan-Ye Su, Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung; Chang Gung University College of Medicine, Taoyuan. 123, Ta-Pei Rd., Niao-Sung District, Kaohsiung, 833, Taiwan; Sleep Center, Kaohsiung Chang Gung Memorial Hospital.
Pei-Wen Lin, Sleep Center, Kaohsiung Chang Gung Memorial Hospital; Division of Glaucoma, Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung; Chang Gung University College of Medicine, Taoyuan, Taiwan.
Hsin-Ching Lin, Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung; Chang Gung University College of Medicine, Taoyuan. 123, Ta-Pei Rd., Niao-Sung District, Kaohsiung, 833, Taiwan; Sleep Center, Kaohsiung Chang Gung Memorial Hospital; Robotic Surgery Center and Center for Quality Management, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of Business Management, National Sun Yat-sen University, Kaohsiung, Taiwan. Electronic address: hclin@adm.cgmh.org.tw.
Chun-Tuan Chang, Department of Business Management, National Sun Yat-sen University, Kaohsiung, Taiwan.Follow
Chih-Yun Lin, Biostatistics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Michael Friedman, Advocate Aurora HealthFollow
Anna M. Salapatas, Advocate Aurora Health

Recommended Citation

Su YY, Lin PW, Lin HC, et al. Systematic review and updated meta-analysis of multi-level surgery for patients with OSA. Auris Nasus Larynx. 2022;49(3):421-430. doi:10.1016/j.anl.2021.10.001

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Objectives: To perform an updated systematic review for determining the surgical success rate of multilevel upper airway surgery for patients with obstructive sleep apnea/hypopnea syndrome (OSA).

Methods: A systematic review was performed to identify English-language studies that evaluated the treatment of adult OSA patients with multilevel OSA surgery up to January, 2018. We used polysomnography as a metric of treatment success. Articles were only included if the surgery intervention involved at least two of the frequently involved anatomic sites: nose, oropharynx and hypopharynx. Eighty-seven studies fit the inclusion criteria and a meta-analysis was performed to determine the overall success.

Results: The meta-analysis included 3931 subjects with a mean age of 46.1 years. The originally reported success rate in the included literature was 59.9%. A meta-analysis was performed to redefine the success rate to be consistent with the commonly agreed upon criteria - namely "a reduction in apnea/hypopnea index (AHI, /hr.) of 50% or more and an AHI of less than 20". The recalculated success rate was 60.2%. Standard meta-analytic techniques for combining p-values between studies after weighting for sample size found significant improvements in AHI, apnea index, % of rapid eye movement sleep, lowest saturation of oxygen (%), and Epworth Sleepiness Scale.

Conclusion: This study shows the significant improvement of treatment outcomes with multilevel surgery for OSA patients.

Document Type

Article

PubMed ID

34736806