Laser-assisted uvulopalatoplasty for the treatment of snoring and mild obstructive sleep apnea syndrome

OBJECTIVE: To determine the efficacy of the laser-assisted uvulopalatoplasty (LAUP) procedure on snoring and Apnea-Hypopnea-Index (AHI) improvement in patients with snoring and mild obstructive sleep apnea syndrome (OSAS). STUDY DESIGN: Prospective, nonrandomized, nonblinded assessment of outcomes after LAUP in patients suffering from benign habitual snoring and/or mild OSAS. METHODS: Fifty-nine patients with habitual snoring and 25 patients with mild OSAS underwent LAUP (6 of them underwent simultaneous classic tonsillectomy and 20 carbon-dioxide laser tonsillotomy). All patients and their bed partners completed pre- and post-treatment questionnaires ranking snoring, whereas the patients with mild OSAS underwent postoperative polysomnography (PSG). RESULTS: During a 6-month to 5-year follow-up (mean 40 months), 91.5% of the patients with habitual snoring reported significant short-term improvement based on post-treatment questionnaires, whereas 79.7% reported long-term subjective improvement. Nineteen of 25 patients (76%) with mild OSAS reported significant improvement of snoring based on posttreatment questionnaires. According to the postoperative PSG, only 2% showed a worse AHI, whereas 60% showed reduction of the AHI to < or = 5. Eight patients (32%) showed little or no improvement of AHI. CONCLUSIONS: LAUP, in combination with carbon-dioxide laser tonsillotomy in some cases, is a safe, cost-effective, outpatient procedure for the treatment of many cases of habitual snoring and mild OSAS when preceded by careful selection of the candidates.