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Beyond uvulopalatopharyngoplasty for obstructive sleep apnoea: single surgeon case series of contemporary airway reconstruction

  • S G MacKay (a1) (a2), N Jefferson (a1) and N S Marshall (a3)



Adult patients with obstructive sleep apnoea can be a therapeutic surgical challenge if other treatments fail or are rejected. We report the outcomes of a series of 17 patients for whom standard device-based treatments failed or could not be used. These patients were considered unsuitable for a lesser operation and therefore underwent multilevel upper airway reconstruction.


Data from 17 consecutive patients were collected prospectively. This included pre- and post-surgery findings for clinical assessments, body mass index, sleep questionnaires, and laboratory polysomnograms. Patients underwent a combination of modified uvulopalatopharyngoplasty, transpalatal advancement and various tongue reduction procedures.


Analyses revealed statistically and clinically significant reductions in: mean apnoea-hypopnoea index scores (from 36.3 pre-operatively to 14.5 post-operatively, p < 0.001), mean Epworth sleepiness scale scores (from 11.3 to 5.3, p < 0.001) and mean snoring severity scores (from 6.9 to 1.3, p < 0.001). Body mass index remained unchanged.


Multilevel upper airway reconstructive surgery was associated with large reductions in both objective and patient-centred subjective measures of obstructive sleep apnoea severity.


Corresponding author

Address for correspondence: Associate Prof S G MacKay, 1–2, 8–10 Victoria St, Wollongong, NSW, Australia2500 Fax: +61 2 4227 6292 E-mail:


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Presented orally at the World Congress of Sleep Apnea (ENT Free Papers session 1), 27 August – 1 September 2012, Rome, Italy.



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