Uvulopalatopharyngoplasty is a valid treatment of obstructive sleep apnea (OSA) in appropriately selected patients. (Sher AE, meta-analysis). After a thorough examination, if the primary area of obstruction has been demonstrated to be the collapse of the velopharynx, surgical modification of this area has been demonstrated to be effective with and without adjunctive procedures (Sher, AE meta-analysis and Friedman M, level 3 evidence). In patients with mild to severe OSA, both simultaneous and serial surgical procedures have been shown to be medically necessary and effective (Friedman M level 3 and Osnes T level 3)
It has been well established that primary surgical treatment should be considered in patients with mild OSA and severe obstructing anatomy that is surgically correctible. (Epstein LJ, Evidence Based Clinical Guideline) In addition, UPPP and other surgical procedures are a successful secondary treatment for OSA and are indicated in patients who have demonstrated treatment failure by continuous positive airway pressure (CPAP) therapy and/or oral appliance therapy. In patients with high AHI, UPPP may also be considered as an adjunct therapy when obstructive anatomy or functional deficiencies compromise other therapies or to improve toler¬ance of other OSA treatments (Epstein LJ, Evidence Based Clinical Guideline).
Submitted for Review 4/13/1995
Submitted for Review 3/1/1998
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Position statements are approved by the American Academy of Otolaryngology—Head and Neck Surgery, Inc. or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official position statements and are added to the existing position statement library. In no sense do they represent a standard of care. The applicability of position statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical position statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this position statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results.
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