By Kelly Young
NEJM Journal Watch
Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD
Combined palatal and tongue surgery may help patients with obstructive sleep apnea that hasn’t responded to other treatments, suggests a preliminary trial in JAMA.
Roughly 100 adults in Australia with moderate-to-severe obstructive sleep apnea (apnea-hypopnea index of 15 or more events per hour of sleep) for whom other treatments had failed were randomized to undergo either surgery or continued medical management that focused on weight loss and lifestyle changes. Surgery consisted of uvulopalatopharyngoplasty and radiofrequency volume reduction of the tongue.
At 6 months, the surgery group had a significantly greater reduction of apnea or hypopnea events than the medical management group (between-group difference, 18 events per hour). The surgery group also reported greater improvements in daytime sleepiness. Two patients in the surgery group (4%) experienced serious adverse events potentially related to the surgery.
Editorialists point out several limitations, including the short follow-up time and the underrepresentation of women and minorities.