Laser sculptural uvulopalatoplasty is an effective method of treating patients with ronchopathy and obstructive sleep apnea

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Introduction. Surgical treatment of patients with ronchopathy and obstructive sleep apnea syndrome (OSAS) is a topical issue of modern medicine. The velopharyngeal muscle injury of various intensity due to surgical interventions on the soft palate leads to inflammation, tissue necrosis or partial rejection and wound healing with a fibrous scar, muscle hypotrophy and hypotonia, palatal ptosis and, as a consequence of this, disease recurrence. Aim. To evaluate the effectiveness of laser surgery on the soft palate in patients with ronchopathy and obstructive sleep apnea syndrome. Materials and methods. The results of examination and treatment of 523 patients with ronchopathy and obstructive sleep apnea syndrome of varying severity aged from 23 to 78 years (men 299, women 224) are presented. Surgical intervention on the soft palate was performed in 352 (67.3%) patients: 309 underwent laser sculptural uvulopalatoplasty, 43 underwent surgery using the Remacl method M. et al. (comparison group). Results and discussion. A comparative analysis of subjective and objective indicators obtained in the same patients according to monitoring computer pulse oximetry, polysomnography and computer somnography before and at different times after laser sculptural uvulopalatoplasty demonstrates persistent and significant (p ≥ 0.005) positive changes. The data from the study of patients in the comparison group demonstrate a positive trend in the results obtained at different times after Remacl surgery M. et al. only if they have uncomplicated snoring and mild OSA. Conclusion. Laser sculptural uvulopalatoplasty is a highly effective method of treating patients with ronchopathy, regardless of the presence and degree of obstructive sleep apnea syndrome. With high-quality and adequate selection for surgery, accurate determination of the levels of obstruction, shape and degree of collapse of the soft tissues of the upper respiratory tract, careful consideration of the individual characteristics of the structure of the soft palate and pharynx and minimization of surgical trauma to the palatine curtain, it is possible to achieve a positive effect of surgery in the vast majority of patients.

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