Does laser-assisted uvulopalatoplasty work? An objective analysis using pre- and postoperative polysomnographic studies.
INTRODUCTION: Since its introduction in 1990, the procedure of laser-assisted uvulopalatoplasty (LAUP) has become a popular alternative to UP3 and other surgical procedures for sleep-disordered breathing. Laser-assisted uvulopalatoplasty has proved to be a relatively simple and cost-effective alternative; however, after almost a decade of use on thousands of patients and many studies that show subjective benefits, very few patients have been followed objectively. PURPOSE: Our purpose was to study in an objective, prospective manner the effects of LAUP on snoring volume and duration as well as on apnea index, respiratory disturbance index (RDI), and desaturation index. METHODS: Fifty consecutive patients were evaluated for sleep-disordered breathing; 43 patients were included in the study, and all had pre- and post-LAUP polysomnograms. Patients were divided into groups depending on their preoperative RDI. All subjects had a pre-LAUP history and physical examination and an otolaryngologic examination, including fibre-optic endoscopy. All patients had a preoperative polysomnographic evaluation. An in-office LAUP using CO2 laser and local anaesthetic was performed on all patients, and all had post-LAUP polysomnography an average of 9.4 weeks postoperatively at the same sleep centre. RESULTS: Overall, we found a significant improvement in 60% of patients, with the greatest benefit in patients with a preoperative RDI of greater than 40 per hour. Patients with preoperative RDI < 20 were successfully treated in only 25% of cases.