ENT - September 2020 - 537

Clinical Study

Investigation of the Effectiveness of Surgical
Treatment on Respiratory Functions
in Patients With Obstructive Sleep
Apnea Syndrome

Ear, Nose & Throat Journal
2020, Vol. 99(8) 537-542
ª The Author(s) 2019
Article reuse guidelines:
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DOI: 10.1177/0145561319840818
journals.sagepub.com/home/ear

Burak Kersin, MD1,2, Murat Karaman, MD3, Engin Aynacı, MD4,
and Ahmet Keles¸ , MD1

Abstract
Objective: Obstructive sleep apnea syndrome (OSAS) is a problem that involves many bodily systems and its effects on the
respiratory system deserve special attention. Although many studies exist that investigate respiratory functions in patients using
continuous positive airway pressure (CPAP) for the treatment of sleep apnea, there is a lack of research regarding the effect of
OSAS surgery on respiratory function in the literature, which has motivated us to perform such a study. Materials and
Methods: Thirty-two patients diagnosed with OSAS with an apnea hypopnea index ranging between 15 and 30 and had
undergone robotic tongue base resection and uvulopharyngoplasty were included as study participants. Pulmonary function tests
were performed on all participants 1 day prior to, and at 3 and 6 months after the operation. Weight and body mass indices (BMIs)
were also recorded at the same intervals for all participants. Data were electronically recorded and analyzed through SPSS 22.0.
Values of P < .05 have been considered as statistically significant. Results: Average age of the 32 participants was 43.2+10.7,
average body weight was 94.1+12.6, and average BMI was 31.4+4.7. Decreases in body weight and BMI values recorded at 3 and
6 months postoperatively had statistical significance when compared with values recorded preoperatively (P < .05). Comparisons
made in terms of pulmonary functions revealed a statistically significant increase in 3 and 6-month postoperative values of FVC,
FEV1, FEV1/FVC, PEF, and FEF 25-75 (P < .05). Conclusion: Our study shows the positive effects of robotic tongue base
resection and uvulopharyngoplasty operation on respiratory function parameters. This suggests that surgical treatment in OSAS
patients is as effective as CPAP on respiratory function.
Keywords
obstructive sleep apnea syndrome, transoral robotic surgery, pulmonary function test

Introduction
Obstructive sleep apnea syndrome (OSAS) is a condition characterized by recurrent total or partial obstruction in the upper
respiratory tract during sleep and decrease in oxygen levels of
blood.1 The gold standard for diagnosis of OSAS is polysomnography (PSG). Polysomnography is indicated in patients
with a suspected OSAS. Polysomnography should also be used
routinely to investigate OSAS in preoperative clinical evaluation in patients who are planned for uvulopalatopharyngoplasty.2 It is required for continuous positive airway pressure
(CPAP) titration to be applied to patients with respiratory problems during sleep. Follow-up PSG should be performed for the
examination of treatment outcomes.2,3
Three important factors play a role in the development of
obstruction in the upper airway; the anatomy of the upper
airways, the negative pressure generated during breathing,
and the loss of activation in the muscles that expand the pharyngeal airway. 4 In patients with OSAS, shortness of the

mandibular size, inferior localization of the hyoid bone, and
retroposition of maxilla have been described with radiological
studies.5
In studies with more advanced imaging modalities (computerized tomography, magnetic resonance imaging), pharyngeal

The Department of Otorhinolaryngology, _Istanbul Medipol University,
Istanbul, Turkey
2
The Department of Otorhinolaryngology, _Istanbul Marmara University,
Istanbul, Turkey
3
The department of Otorhinolaryngology, Acıbadem University, Istanbul,
Turkey
4
The Department of Pulmonology, _Istanbul Medipol University, Istanbul,
Turkey
1

Corresponding Author:
Murat Karaman, MD, Department of Otorhinolaryngology, Acıbadem
University, _Istanbul, Turkey.
Email: karaman1398@yahoo.com


https://www.sagepub.com/journals-permissions https://www.doi.org/10.1177/0145561319840818 http://journals.sagepub.com/home/ear

ENT - September 2020

Table of Contents for the Digital Edition of ENT - September 2020

The Creation of a Sustainable Otolaryngology Department in Malawi Nathan Douglas Vandjelovic, Eric Masao Sugihara, Wakisa Mulwafu, and David Nathan Madgy
Hazardous Grilling Due to Wire Brushes Nima A. Vahidi, Brenna A. Keane, Paul J. Whalen, and Anita Jeyakumar
Guns n’ Noses: Endoscopic Removal of an Air-Gun Pellet Retained in the Frontal Sinus Dylan A. Levy, Andrew Y. Lee, Waleed M. Abuzeid, and Nadeem A. Akbar
Vitamin D Status in Egyptian Children With Allergic Rhinitis Khaled Saad, Abobakr Abdelmoghny, Mohamed Diab Aboul-Khair, Yasser Farouk Abdel-Raheem, Eman Fathalla Gad, Ahmed El-Sayed Hammour, Bahaa Hawary, Asmaa M. Zahran, Mohamd A. Alblihed, and Amira Elhoufey
Pediatric Epistaxis and Its Correlation Between Air Pollutants in Beijing From 2014 to 2017 Ying-Xia Lu, Jie-Qiong Liang, Qing-Long Gu, Chong Pang, and Chun-Lei Huang
Otomycosis With Tympanic Membrane Perforation: A Review of the Literature Petros Koltsidopoulos and Charalampos Skoulakis
Simultaneous Bilateral Same-Day Endoscopic Myringoplasty Using Tragal Cartilage From One Ear Baklaci Deniz, Kuzucu Ihsan, Guler Ismail, Kum Rauf Oguzhan, and Ozcan Muge
A Preliminary Report on the Investigation of Prestin as a Biomarker for Idiopathic Sudden Sensorineural Hearing Loss Changling Sun, Xiaolin Xuan, Zhi Zhou, Yuan Yuan, and Fei Xue
A Retrospective Study to Identify the Relationship Between the Dimension of Osseous External Auditory Canal and Chronic Otitis Media Yi-Fang Lee, Pei-Yin Wei, Chia-Huei Chu, Wen-Huei Liao, An-Suey Shiao, and Mao-Che Wang
Investigation of the Effectiveness of Surgical Treatment on Respiratory Functions in Patients With Obstructive Sleep Apnea Syndrome Burak Kersin, Murat Karaman, Engin Aynacı, and Ahmet Keles
Changing Trends of Color of Different Laryngeal Regions in Laryngopharyngeal Reflux Disease Chen Du, Paige Thayer, Yan Yan, Qingsong Liu, Li Wang, and Jack Jiang
ENT - September 2020 - Intro
ENT - September 2020 - Cover1
ENT - September 2020 - Cover2
ENT - September 2020 - 489
ENT - September 2020 - 490
ENT - September 2020 - 491
ENT - September 2020 - 492
ENT - September 2020 - 493
ENT - September 2020 - 494
ENT - September 2020 - 495
ENT - September 2020 - 496
ENT - September 2020 - 497
ENT - September 2020 - 498
ENT - September 2020 - 499
ENT - September 2020 - 500
ENT - September 2020 - The Creation of a Sustainable Otolaryngology Department in Malawi Nathan Douglas Vandjelovic, Eric Masao Sugihara, Wakisa Mulwafu, and David Nathan Madgy
ENT - September 2020 - 502
ENT - September 2020 - Hazardous Grilling Due to Wire Brushes Nima A. Vahidi, Brenna A. Keane, Paul J. Whalen, and Anita Jeyakumar
ENT - September 2020 - 504
ENT - September 2020 - Guns n’ Noses: Endoscopic Removal of an Air-Gun Pellet Retained in the Frontal Sinus Dylan A. Levy, Andrew Y. Lee, Waleed M. Abuzeid, and Nadeem A. Akbar
ENT - September 2020 - 506
ENT - September 2020 - 507
ENT - September 2020 - Vitamin D Status in Egyptian Children With Allergic Rhinitis Khaled Saad, Abobakr Abdelmoghny, Mohamed Diab Aboul-Khair, Yasser Farouk Abdel-Raheem, Eman Fathalla Gad, Ahmed El-Sayed Hammour, Bahaa Hawary, Asmaa M. Zahran, Mohamd A. Alblihed, and Amira Elhoufey
ENT - September 2020 - 509
ENT - September 2020 - 510
ENT - September 2020 - 511
ENT - September 2020 - 512
ENT - September 2020 - Pediatric Epistaxis and Its Correlation Between Air Pollutants in Beijing From 2014 to 2017 Ying-Xia Lu, Jie-Qiong Liang, Qing-Long Gu, Chong Pang, and Chun-Lei Huang
ENT - September 2020 - 514
ENT - September 2020 - 515
ENT - September 2020 - 516
ENT - September 2020 - 517
ENT - September 2020 - Otomycosis With Tympanic Membrane Perforation: A Review of the Literature Petros Koltsidopoulos and Charalampos Skoulakis
ENT - September 2020 - 519
ENT - September 2020 - 520
ENT - September 2020 - 521
ENT - September 2020 - Simultaneous Bilateral Same-Day Endoscopic Myringoplasty Using Tragal Cartilage From One Ear Baklaci Deniz, Kuzucu Ihsan, Guler Ismail, Kum Rauf Oguzhan, and Ozcan Muge
ENT - September 2020 - 523
ENT - September 2020 - 524
ENT - September 2020 - 525
ENT - September 2020 - 526
ENT - September 2020 - 527
ENT - September 2020 - A Preliminary Report on the Investigation of Prestin as a Biomarker for Idiopathic Sudden Sensorineural Hearing Loss Changling Sun, Xiaolin Xuan, Zhi Zhou, Yuan Yuan, and Fei Xue
ENT - September 2020 - 529
ENT - September 2020 - 530
ENT - September 2020 - 531
ENT - September 2020 - A Retrospective Study to Identify the Relationship Between the Dimension of Osseous External Auditory Canal and Chronic Otitis Media Yi-Fang Lee, Pei-Yin Wei, Chia-Huei Chu, Wen-Huei Liao, An-Suey Shiao, and Mao-Che Wang
ENT - September 2020 - 533
ENT - September 2020 - 534
ENT - September 2020 - 535
ENT - September 2020 - 536
ENT - September 2020 - Investigation of the Effectiveness of Surgical Treatment on Respiratory Functions in Patients With Obstructive Sleep Apnea Syndrome Burak Kersin, Murat Karaman, Engin Aynacı, and Ahmet Keles
ENT - September 2020 - 538
ENT - September 2020 - 539
ENT - September 2020 - 540
ENT - September 2020 - 541
ENT - September 2020 - 542
ENT - September 2020 - Changing Trends of Color of Different Laryngeal Regions in Laryngopharyngeal Reflux Disease Chen Du, Paige Thayer, Yan Yan, Qingsong Liu, Li Wang, and Jack Jiang
ENT - September 2020 - 544
ENT - September 2020 - 545
ENT - September 2020 - 546
ENT - September 2020 - 547
ENT - September 2020 - 548
ENT - September 2020 - 549
ENT - September 2020 - 550
ENT - September 2020 - 551
ENT - September 2020 - 552
ENT - September 2020 - Cover3
ENT - September 2020 - Cover4
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