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Cirugía para la apnea obstructiva del sueño en adultos

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Referencias

Referencias de los estudios incluidos en esta revisión

Ir a:

Atef 2005 {published data only}

Atef A, Mosleh M, Hesham M, Fathi A, Hassan M, Fawzy M. Radiofrequency versus laser in the management of mild to moderate obstructive sleep apnoea: Does the number of treatment sessions matter?. Journal of Laryngology & Otology 2005;119(11):888‐93.

Bassiouny 2007 {published data only}

Bassiouny A, El Salamawy A, Abd El‐Tawab M, Atef A. Bipolar radiofrequency treatment for snoring with mild to moderate sleep apnea: A comparative study between the radiofrequency assisted uvulopalatoplasty technique and the channeling technique. European Archives of Oto‐Rhino‐Laryngology 2007;264(6):659‐67.

Cahali 2004 {published data only}

Cahali MB. Lateral pharyngoplasty: a new treatment for obstructive sleep apnea hypopnea syndrome. Laryngoscope 2003;113(113):1961‐8.
Cahali MB, Formigoni GG, Gebrim EM, Miziara ID. Lateral pharyngoplasty versus uvulopalatopharyngoplasty: a clinical, polysomnographic and computed tomography measurement comparison. Sleep 2004;27(5):942‐50.

Ferguson 2003 {published data only}

Ferguson KA, Heighway K, Ruby RR. A randomized trial of laser‐assisted uvulopalatoplasty in the treatment of mild obstructive sleep apnea. American Journal of Respiratory Critical Care Medicine 2003;167:15‐9.
Ferguson KA, Heighway K, Ruby RR. Laser‐assisted uvulopalatoplasty for the treatment of obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine 1998;157(Suppl 3):A285.

Friedman 2008 {published data only}

Friedman M, Schalch P, Lin HC, Kakodkar KA, Joseph NJ, Mazloom N. Palatal implants for the treatment of snoring and obstructive sleep apnea/hypopnea syndrome. Otolaryngology ‐ Head & Neck Surgery 2008;138(2):209‐16.

Larrosa 2004 {published data only}

Larrosa F, Hernandez L, Morello A, Ballester E, Quinto L, Montserrat JM. Laser‐assisted uvulopalatoplasty for snoring: Does it meet the expectations?. European Respiratory Journal 2004;24(1):66‐70.

Lojander 1996 {published and unpublished data}

Lojander J, Kajaste S, Maasilta P, Partinen M. Cognitive function and treatment of obstructive sleep apnea syndrome. Journal of Sleep Research 1999;8(1):71‐6.
Lojander J, Maasilta P, Partinnen M, Brander PE, Salmi T, Lehtonen H. Nasal CPAP, surgery and conservative treatment of management of treatment for OSA syndrome. Chest 1996;110(1):114‐8.

Naya 2002 {published data only}

Naya MJ, Vicente EA, Asin J, Gargallo P. Multi‐level treatment for obstructive sleep apnea syndrome: comparative study of four different surgical techniques of palate [Traitamiento multinivel en el síndrome de apnea obstructiva del sueño: estudio comparativo de cuartro técnicas quirùrgicas del paladar]. Acta Otorrinolaringologica Espanola 2002;53(2):110‐20.

Pang 2007 {published data only}

Pang KP, Woodson BT. Expansion sphincter pharyngoplasty: a new technique for the treatment of obstructive sleep apnea.. Otolaryngology‐‐Head and Neck Surgery : Official Journal of American Academy of Otolaryngology‐Head and Neck Surgery 2007;137(1):110‐4.

Tegelberg 1999 {published data only}

Ringqvist M, Walker‐Engstrom ML, Tegelberg A, Ringqvist I. Dental and skeletal changes after 4 years of obstructive sleep apnea treatment with a mandibular advancement device: a prospective, randomized study. American Journal of Orthodontics & Dentofacial Orthopedics 2003;124(1):53‐60.
Tegelberg A, Wilhelmsson B, Walker‐Engstrom ML, Ringqvist M, Andersson L, Krekamanov L, et al. Effects and adverse events of a dental appliance for treatment of obstructive sleep apnoea. Swedish Dental Journal 1999;23(4):117‐26.
Walker‐Engstrom ML, Tegelberg A, Wilhelmsson B, Ringqvist I. 4‐year follow‐up of treatment with dental appliance or uvuloplaltopharyngoplasty in patients with obstructive sleep apnoea. Chest 2002;121(3):739‐46.
Walker‐Engstrom ML, Wilhelmsson B, Tegelberg A, Dimenas E, Ringqvist I. Quality of Life measurements of treatment with dental appliance or UPPPin patients with mild to moderate obstructive slep apnoea. A prospective randomized 1 year follow‐up study. Journal of Sleep Research 2000;9(3):303‐8.
Wilhelmsson B, Tegelberg A, Walker‐Engstrom ML, Ringqvist M, Andersson L, Krekmanov L, et al. A prospective randomized study of a dental appliance compared with uvulppalatopharngoplasty in the treatment of obstructive sleep apnoea. Acta Oto‐laryngologica 1999;119:503‐9.

Thomas 2003 {published data only}

Thomas AJ, Chavoya M, Terris DJ. Preliminary findings from a prospective, randomized trial of two tongue‐base surgeries for sleep‐disordered breathing. Otolaryngology ‐ Head & Neck Surgery 2003;129(5):539‐46.

Woodson 2003 {published data only}

Steward DL, Weaver EM, Woodson BT. A comparison of radiofrequency treatment schemes for obstructive sleep apnea syndrome. Otolaryngology ‐ Head & Neck Surgery 2004;130(5):579‐85.
Weaver EM, Woodson BT, Steward DL. Polysomnography indexes are discordant with quality of life, symptoms, and reaction times in sleep apnea patients. Otolaryngology ‐ Head & Neck Surgery 2005;132(2):255‐62.
Woodson BT, Steward DL, Weaver EM. Outcomes of non‐attended home autosetting CPAP titration. Sleep Medicine 2003;4(Suppl 1):S53.
Woodson BT, Steward DL, Weaver EM, Javaheri S. A randomized trial of temperature‐controlled radiofrequency, continuous positive airway pressure, and placebo for obstructive sleep apnea syndrome. Otolaryngology ‐ Head & Neck Surgery 2003;128(6):848‐61.

Referencias de los estudios excluidos de esta revisión

Ir a:

Abe 1996 {published data only}

Abe K, Hori Y, Ohtsu S, Koike Y. A case of non‐Hodgkin's lymphoma with macroglobulinemia. Acta Oto‐Laryngologica 1996;523:259‐62.

Achena 1991 {published data only}

Achena F, Medda C. Tonsillectomy in childhood: personal considerations. Acta Otorhinolaryngologica Italica 1991;11(6):595‐601.

Afzelius 1981 {published data only}

Afzelius LE, Elmqvist D, Hougaard K, Laurin S, Nilson B, Risberg AM. Sleep apnea syndrome: an alternative treatment to tracheostomy. Laryngoscope 1981;91:285‐91.

Anand 1991 {published data only}

Anand VK, Ferguson PW, Schoen LW. Obstructive sleep apnea: a comparison of continuous positive airway pressure and surgical treatment. Otolaryngology and Head and Neck Surgery 1991;105:382‐90.

Anon 1996 {published data only}

Anonymous. Sleep apnea: is your patient at risk?. American Family Physician 1996;53(1):247‐53.

ASDA 1996 {published data only}

American Sleep Disorders Association. Practice parameters for the treatment of obstructive sleep apnea in adults: the efficacy of surgical modifications of the upper airway. Sleep 1996;19(2):152‐5.

Aspinall 2001 {published data only}

Aspinall RL, Mayor A. A prospective randomized controlled study of the efficacy of ketamine for postoperative pain relief in children after adenotonsillectomy. Paediatric Anaesthesia 2001;11:333‐6.

Aubert‐Tulkens 1987 {published data only}

Aubert‐Tulkens G, Culee C, Harmant‐Van Rijckevorsel K, Rodenstein DO. Ambulatory evaluation of sleep disturbance and therapeutic effects in sleep apnoea syndrome by wrist activity monitoring. American Review of Respiratory Disease 1987;136:851‐6.

Balcerzak 2005 {published data only}

Balcerzak J, Arcimowicz M, Byskiniewicz K, Bielicki P, Korczynski P, Niemczyk K, et al. Influence of nasal obstruction on subjective assessment of sleep quality by the patients with obstructive sleep apnea. Polski Merkuriusz Lekarsk 2005;19(111):286‐7.

Banerjee 1995 {published data only}

Banerjee AR, Prichard AJ, Thomas RS. Surgery of the upper airway. Bailliere's Clinical Anaesthesiology 1995;9(2):317‐35.

Bear 1980 {published data only}

Bear SE, Priest JH. Sleep apnea syndrome: correction with surgical management of the mandible. Journal of Oral Surgery 1980;38:543.

Bernecker 1993 {published data only}

Bernecker F, Stasche N, Hormann K. Snoring and sleep apnea syndrome: Surgical treatment and MESAM‐IV‐controlled, postoperative results. Laryngo‐Rhino‐Otologie 1993;72(8):398‐401.

Blakley 1986 {published data only}

Blakley BW, Maisel RH, Mahowald M, Ettinger M. Sleep parameters after surgery for obstructive sleep apnea. Otolaryngology ‐ Head & Neck Surgery 1986;95(1):23‐8.

Borowiecki 1985 {published data only}

Borowiecki BD, Sassin JF. Surgical Treatment of sleep apnea. Archives of Otolaryngology 1985;109:508‐12.

Boudewyns 1995 {published data only}

Boudewyns AN, Van de Heyning PH. Obstructive sleep apnea syndrome in children: an overview. Oto‐Rhino‐Laryngologica Belgica 1995;49(3):275‐9.

Bower 1995 {published data only}

Bower CM, Richmond D. Tonsillectomy and adenoidectomy in patients with Down syndrome. International Journal of Pediatric Otorhinolaryngology 1995;33(2):141‐8.

Breaux 1995 {published data only}

Breauz CW. Obesity surgery in children. Obesity Surgery 1995;5(3):279‐84.

Brock 1994 {published data only}

Brock ET, Shucard DW. Sleep apnea. American Family Physician 1994;49(2):385‐94.

Brodsky 1987 {published data only}

Brodsky L, Moore L, Stanievich JF. A comparison of tonsillar size and oropharyngeal dimensions in children with obstructive adenotonsillar hypertrophy. International Journal of Pediatric Otorhinolaryngology 1987;13(2):149‐56.

Brouilette 1984 {published data only}

Brouilette R, Hanson D, David R, Klemka L, Szatkowski A, Fernbach S, et al. A diagnostic approach to suspected obstructive sleep apnea in children. Journal of Pediatrics 1984;105(1):10‐4.

Burbach 1993 {published data only}

Burbach R, Kirchheiner T, Ruhle KH. The frequency of otorhinolaryngological operations in patients with obstructive sleep apnea syndrome. Journal of Pediatrics 1993;19:322‐4.

Burstein 1995 {published data only}

Burstein FD, Cohen SR, Scott PH, Teague GR, Montgomery GL, Kattos AV. Surgical therapy for severe refractory sleep apnea in infants and children: application of the airway zone concept. Plastic & Reconstructive Surgery 1995;96(1):34‐41.

Byrd 1996 {published data only}

Byrd JR, Roy TM, Mehta JB. Plasmacytoma as a cause of obstructive sleep apnea. Chest 1996;109(6):1657‐9.

Callanan 1994 {published data only}

Callanan V, O'Connor AFF. Adult and paediatric tracheostomy ‐ Technique, complications and alternatives. Current Practice in Surgery 1994;6(4):219‐23.

Calverley 1995 {published data only}

Calverley PM. Sleep‐related breathing disorders. Introduction. Thorax 1995;50:682.

Carenfelt 1993 {published data only}

Carenfelt C, Haraldsson PO. Frequency of complications after uvulopalatopharyngoplasty. Lancet 1993;341(8842):437.

Cartwright 1988 {published data only}

Cartwright R, Stefoski D, Caldarelli D, Kravitz H, Knight S, Lloyd S, et al. Toward a treatment logic for sleep apnea: The place of the tongue retaining device. Behaviour Research and Therapy 1988;26(2):121‐6.

Castiglione 1992 {published data only}

Castiglione N, Eterno C, Sciuto C, Bottaro G, La Rosa M, Patane R. The diagnostic approach to and clinical study of 23 children with an obstructive sleep apnea syndrome. Pediatria Medica e Chirurgica 1992;14(5):501‐6.

Chabolle 1988 {published data only}

Chabolle F, Fleury B, Riu B, Meyer B, Chouard CH. Results of uvulopalatopharyngoplasty in sleep apnea syndromes. Apropos of 33 cases. Annales d'Oto‐laryngologie et de Chirurgie Cervico‐Faciale 1988;105(4):283‐9.

Chabolle 1995 {published data only}

Chabolle F, Sequert C, Fleury B, Lachiver X, Carles P, Salf E, et al. Analysis of results of pharyngotomy in the surgical treatment of sleep apnea syndrome. Apropos of 150 cases. Annales d'Oto‐laryngologie et de Chirurgie Cervico‐Faciale 1995;112(3):98‐106.

Chabolle 1995a {published data only}

Chabolle F, Sequert C, Lachiver X, Fleury B, Pandraud L, Azan L. A new technique of gene transposition in the surgical treatment of sleep apnea syndrome. Annales d'Oto‐laryngologie et de Chirurgie Cervico‐Faciale 1995;112(4):164‐8.

Chaska 1995 {published data only}

Chaska B, Millman RP, Phillips BA, Srohl KP, Strollo PJ, Suratt PM, et al. Sleep apnea: is your patient at risk? ... a special article from the National Heart, Lung, and Blood Institute ... reprinted with permission. Respiratory Care 1995;40(12):1287‐98.

Chetty 1994 {published data only}

Chetty KG, Kadifa F, Berry RB, Mahutte CK. Acquired laryngomalacia as a cause of obstructive sleep apnea. Chest 1994;106(6):1898‐9.

Chua 1994 {published data only}

Chua W, Chediak AD. Obstructive sleep apnea. Treatment improves quality of life‐and may prevent death. Postgraduate Medicine 1994;95(2):123‐38.

Cimimo 1995 {published data only}

Cimimo A, Speciale R, Gallina S, Cimimo M, Marrone O, Salvaggio A, et al. The surgical treatment of obstructive sleep apnea syndrome. Acta Otorhinolaryngologica Italica 1995;15(2 Suppl 47):3‐14.

Cimimo 1995a {published data only}

Cimino A, Speciale R, Gallina S, Cimino M, Cimino G, De Feo G, et al. Morphologic and ultrastructural changes of soft palate in patients who underwent palatopharyngoplasty. Acta Otorhinolaryngologica 1995;15(2 Suppl 47):18‐23.

Clauser 1996 {published data only}

Clauser L, Marchetti C, Piccione M, Bertoni F. Craniofacial fibrous dysplasia and Ollier's disease: Combined transfrontal and transfacial resection using the nasal‐cheek flap. Journal of Craniofacial Surgery 1996;7(2):140‐4.

Clerk 1994 {published data only}

Clerk AA, Dunan SR, Guilleminault C. Load detection in subjects with sleep‐induced upper airway obstruction. American Journal of Respiratory & Critical Care Medicine 1994;149(3 Pt 1):727‐30.

Coleman 1991 {published data only}

Coleman RF, Sly DE. Preoperative and postoperative voice analysis of uvulopalatopharyngoplasty patients. Archives of Otolaryngology ‐ Head & Neck Surgery 1991;117(12):1345‐9.

Crampette 1992 {published data only}

Crampette L, Carlander B, Mondain M, Billiard M, Guerrier B, Dejean Y. Surgical alternatives to uvulopalatopharyngoplasty in sleep apnea syndrome. Sleep 1992;15:S63‐8.

Croft 1990 {published data only}

Croft CB, Brockbank MJ, Wright A, Swanston AR. Obstructive sleep apnea in children undergoing routine tonsillectomy and adenoidectomy. Clinical Otolaryngology 1990;15(4):307‐14.

Cvetnic 1995 {published data only}

Cvetnic V. Surgical treatment of snoring in children ‐ prevention of obstructuve sleep apnea syndrome. Paediatria Croatica 1995;39(4):199‐201.

Dickson 1987 {published data only}

Dickson RI, Blokmanis A. Treatment of obstructive sleep apnea syndrome by uvulopalatopharyngoplasty. Laryngoscope 1987;97:1054‐9.

Dierks 1990 {published data only}

Dierks E, Geller M, Roffwarg H. Obstructive sleep apnea syndrome: correction by mandibular advancement. The Southern Medical Journal 1990;93:390‐4.

Djupesland 1992 {published data only}

Djupesland G, Schrader H, Lyberg T. Palatopharyngoglossoplasty in the treatment of patients with obstructive sleep apnea syndrome. Acta Oto‐laryngologica 1992;492(Suppl):50‐4.

Doghramji 1995 {published data only}

Doghramji K, Jabourian ZH, Pilla M, Farole A, Lindholm RN. Predictors of outcome for uvulopalatopharyngoplasty. Laryngoscope 1995;105:311‐4.

Donnelly 1994 {published data only}

Donnelly MJ, Quraishi MS, McShane DP. Indications for paediatric tonsillectomy GP versus Consultant perspective. Journal of Laryngology & Otology 1994;108(2):131‐4.

Douglas 1994a {published data only}

Douglas NJ. Sleep apnea/hypopnoea syndrome. Scottish Medical Journal 1994;39(6):168‐9.

Douglas 1994b {published data only}

Douglas NJ, Polo O. Pathogenesis of obstructive sleep apnoea / hypopnoea syndrome. Lancet 1994;344:653‐5.

Douglas 1995 {published data only}

Douglas NJ. How to reach a diagnosis in patients who may have the sleep apnoea / hypopnoea syndrome. Thorax 1995;50:883‐6.

Ejnell 1992 {published data only}

Ejnell H, Bjorkman R, Wahlander L, Hedner J. Treatment of postoperative pain with diclofenac in uvulopalatopharyngoplasty. British Journal of Anaesthesia 1992;68(1):76‐80.

ElSheikh 1996 {published data only}

ElSheikh MM, Medra AM, Warda MH. Bird face deformity secondary to bilateral temporomandibular joint ankylosis. Journal of Cranio‐Maxillo‐Facial Surgery 1996;24(2):96‐103.

Engleman 1994 {published data only}

Engleman HM, Martin SE, Deary IJ, Douglas NJ. Effect of continuous positive airways pressure treatment on daytime function in sleep apnoea / hypopnoea syndrome. Lancet 1994;343:572‐5.

Fietze 1993 {published data only}

Fietze I, Warmuth R, Quispe‐Bravo S, Waschke K. Therpeutic consequences of obstructive sleep apnea syndrome ‐ results of drug, mechanical and surgical treatment. Pneumologie 1993;47(Suppl 4):716‐21.

Findley 1989 {published data only}

Findley LJ, Fabrizio MJ, Knight H, Norcross BB, Laforte AJ, Suratt PM. Driving simulator performance in patients with sleep apnea. American Review of Respiratory Disease 1989;140:529‐30.

Finkelstein 1995 {published data only}

Finkelstein Y, Shifman A, Nachmani A, Ophir D. Prosthetic management of velopharyngeal insufficiency induced by uvulopalatopharyngoplasty. Otolaryngology ‐ Head and Neck Surgery 1995;113(5):611‐6.

Finkelstein 1995a {published data only}

Finkelstein Y, Talmi YP, Raveh E, Orlin J, Rudnicki C, Fried M, et al. Can obstructive sleep apnea be a complication of uvulopalatopharyngoplasty?. Journal of Laryngology and Otology 1995;109(3):212‐7.

Fraser 1994 {published data only}

Fraser AK. Obstructive sleep apnoea and allied disorders. A needs assessment. National Services Division, Common Services Agency, Scotland1994.

Freezer 1995 {published data only}

Freezer NJ, Bucens IK, Robertson CF. Obstructive sleep apnoea presenting as failure to thrive in infancy. Journal of Paediatrics & Child Health 1995;31(3):172‐5.

Freezer 1996 {published data only}

Freezer NJ, Bucens IK, Robertson CF. Obstructive sleep apnea presenting as failure to thrive in infancy. Neonatal Intensive Care 1996;9(1):35‐8.

Friberg 1995 {published data only}

Friberg D, CarlssonNorlander B, Larsson H, Svanborg E. UPPP for habitual snoring: A 5‐year follow‐up with respiratory sleep recordings. Laryngoscope 1995;105(5 I):519‐22.

Fried 1995 {published data only}

Fried D. On tonsillectomy: Mom's personal experience. Lancet 1995;346(8976):714.

Frith 1985 {published data only}

Frith RW, Cant BR. Obstructive sleep apnoea in Auckland: diagnosis and treatment. New Zealand Medical Journal 1985;98(786):745‐8.

Fujita 1981 {published data only}

Fujita S, Conway WA, Zorick FJ. Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngology‐ Head and Neck Surgery 1981;89(6):923‐34.

Fujita 1985 {published data only}

Fujita S, Conway WA, Sicklesteel J. Evaluation of the effectiveness of uvulopalatopharyngoplasty. Laryngoscope 1985;95:70‐4.

Fujita 1991 {published data only}

Fujita S. Midline laser glossectomy with linguoplasty: a treatment of sleep apnea syndrome. Op Tech Otolaryngol HNS 1991;2:127‐31.

Fujita 1991a {published data only}

Fujita S, Woodson BT, Clark J. Laser midline glossectomy as treatment for obstructive sleep apnea. Laryngoscope 1991;101(8):805‐9.

Furlow 1986 {published data only}

Furlow LT, Block AJ, Williams WN. Obstructive sleep apnea following treatment of velopharyngeal incompetence by Teflon injection. Cleft Palate Journal 1986;23(2):153‐8.

Gislason 1988 {published data only}

Gislason T, Lindhilm CE, Almqvist M. Uvulopalatopharyngoplasty in the sleep apnoea syndrome. Archives of Otolaryngology ‐ Head & Neck Surgery 1988;114:45‐51.

Grunstein 1995 {published data only}

Grunstein RR. Nasal continuous airway pressure treatment for obstructive sleep apnoea. Thorax 1995;50:1106‐13.

Gryczynska 1995 {published data only}

Gryczynska D, Powajbo K, Zakrzewska A. The influence of tonsillectomy on obstructive sleep apnea children with malocclusion. International Journal of Pediatric Otorhinolaryngology 1995;32(Suppl):S225‐8.

Guileminault 1986 {published data only}

Guilleminault C, Nino‐Murcia G, Heldt G, Baldwin R, Hutchinson D. Alternative treatment to tracheostomy in obstructive sleep apnea syndrome: nasal continuous positive airway pressure in young children. Pediatrics 1986;78(5):797‐802.

Guilleminault 1983 {published data only}

Guilleminault C, Hayes B, Smith L, Simmons FB. Palatopharyngoplasty and obstructive sleep apnea syndrome. Bulletin Europeen de Physiopathologie Respiratoire 1983;19:595‐9.

Haraldsson 1990 {published data only}

Haraldsson PO, Carenfelt C, Diderichsen F, Nygren A, Tingvall C. Clinical symptoms of sleep apnea syndrome and automobile accidents. ORL; Journal for oto‐rhino‐laryngology and its related specialties 1990;52:57‐60.

Haraldsson 1995 {published data only}

Haraldsson PO, Carenfelt C, Lysdahl M, Tornros J. Long‐term effect of uvulopalatolaryngoplasty on driving performance. Archives of Otolaryngology ‐ Head & Neck Surgery 1995;121(1):90‐4.

Haraldsson 1995a {published data only}

Haraldsson PO, Carenfelt C, Lysdahl M, Tingvall C. Does uvulopalatopharyngoplasty inhibit automobile accidents?. Laryngoscope 1995;105(6):657‐61.

Harmon 1986 {published data only}

Harmon JD, Chaudhary BA. Uvulopalatoplasty and obstructive sleep apnea. The Southern Medical Journal 1986;79(2):197‐200.

He 1988 {published data only}

He J, Kryger MH, Zorick FJ, Conway W, Roth T. Mortality and apnoea index in obstructive sleep apnoea. Experience in 385 male patients. Chest 1988;94(1):9‐14.

Hester 1995 {published data only}

Hester TO, Phillips B, Archer SM. Surgery for obstructive sleep apnea: effects on sleep, breathing, and oxygenation. The Southern Medical Journal 1995;88(9):907‐10.

Hochban 1994 {published data only}

Hochban W, Brandenburg U, Peter JH. Surgical treatment of obstructive sleep apnea by maxillomandibular advancement. Sleep 1994;17(7):624‐9.

Hochban 1995 {published data only}

Hochban W, Brandenburg U, Peter JH. Surgical treatment of obstructive sleep apnea by maxilliary and mandibular osteotomy. Fortschritte der Kiefer ‐ und Gesichts‐Chirurgie 1995;40:65‐72.

Hochban 1995a {published data only}

Hochban W, Brandenburg U, Peter JH. Surgical treatment of obstructive sleep apnea by osteotomy of the facial bones (results of 1 year). Pneumologie 1995;49(Suppl 1):175‐9.

Hochban 1996 {published data only}

Hochban W. Surgical treatment of obstructive sleep apnea. Atemwegs‐ und Lungenkrankheiten 1996;22(4):217‐22.

Hoffman 1995 {published data only}

Hoffman RM, Stiller RA. Resolution of obstructive sleep apnea after microvascular brainstem decompression. Chest 1995;107(2):570‐2.

Hoffstein 1996 {published data only}

Hoffstein V. Snoring. Chest 1996;109(1):201‐22.

Hoijer 1992 {published data only}

Hoijer U, Ejnell H, Hedner J. Obstructive sleep apnea in patients with pharyngeal tumours. Acta Oto‐Laryngologica 1992;112(1):138‐43.

Hudgel 1991 {published data only}

Hudgel DW, Harasick T, Katz RL. Uvulopalatopharyngoplasty in obstructive apnea. American Review of Respiratory Disease 1991;143:942‐6.

Hudgel 1996 {published data only}

Hudgel DW. Treatment of obstructive sleep apnea: a review. Chest 1996;109(5):1346‐58.

Hultcrantz 1999 {published data only}

Hultcrantz E, Linder A, Markstrom A. Tonsillectomy or tonsillotomy? A randomised study comparing postoperative pain and long‐term effects. International Journal of Pediatric Otorhinolaryngology 1999;51:171‐6.

Ishizuka 1996 {published data only}

Ishizuka Y, Kakuta H. Treatment of sleep apnea and snoring in children. Acta Oto‐Laryngologica 1996;523(Suppl):234‐5.

Jakubikova 1996 {published data only}

Jakubikova J, Zitnan D, Batorova A. An unusual reason for obstructive sleep apnea in a boy with hemophilia B: Supraglottic papilloma. International Journal of Pediatric Otorhinolaryngology 1996;34(1‐2):165‐9.

Janson 1994 {published data only}

Janson C, Hillerdal G, Larsson L, Hultcrantz E, Lindholm CE, Bengtsson H, et al. Excessive daytime sleepiness and fatigue in nonapnoeic snorers: Improvement after UPPP. European Respiratory Journal 1994;7(5):845‐9.

Johnson 1994 {published data only}

Johnson NT, Chinn J. Uvulopalatopharyngoplasty and and inferior sagittal mandibular osteotomy with genioglossus advancement for treatment of obstructive sleep apnea. Chest 1994;105:278‐83.

Kamami 1994 {published data only}

Kamami Y. Outpatient treatment of sleep apnea syndrome with CO2 laser: Laser assisted UPPP. Journal of Otolaryngology 1994;23(6):395‐8.

Kamami 1994a {published data only}

Kamami YV. Outpatient treatment of snoring with CO2 laser: Laser‐Assisted UPPP. Journal of Otolaryngology 1994;23(6):391‐4.

Kanami 1994 {published data only}

Kanami YV. Ambulatory treatment of sleep apnea syndrome with CO2 laser (LAUP). Review of 53 cases. Journal Francais d'Oto‐Rhino‐Laryngologie 1994;43(3):183‐90.

Katsantonis 1988 {published data only}

Katsantonis GP, Schweitzer PK, Branham GH, Chambers G, Walsh J, K. Management of obstructive sleep apnea: comparison of various treatment modalities. Laryngoscope 1988;98(3):304‐9.

Kawano 1996 {published data only}

Kawano K, Usui N, Kanazawa H, Hara I. Changes in nasal and oral respiratory resistance before and after uvulopalotopharyngoplasty. Acta Oto‐Laryngologica 1996;523(Suppl):236‐8.

Keenan 1994 {published data only}

Keenan SP, Burt H, Ryan CF, Fleetham JA. Long‐term survival of patients with obstructive sleep apnoea treated by uvulopalatopharyngoplasty or nasal CPAP. Chest 1994;105(1):155‐9.

Keilmann 1995 {published data only}

Keilmann A, Nett S, Hormann K. Effects of surgical therapy of obstructive snoring on swallowing and voice quality. Laryngo‐Rhino‐Otologie 1995;74(9):555‐8.

Khan 1995 {published data only}

Khan W, Gleason R, Strome M, Regestein Q. Clinical features as diagnostic guides in obstructive sleep apnea. Comprehensive psychiatry 1995;36(1):46‐52.

Kimmelman 1985 {published data only}

Kimmelman CP, Levine SB, Shore ET, Millman RP. Uvulopalatopharyngoplasty: a comparison of two techniques. Laryngoscope 1985;95(12):1488‐90.

Klonoff 1987 {published data only}

Klonoff H, Fleetham J, Taylor DR, Clark C. Treatment outcome of obstructive sleep apnea. Physiological and neuropsychological concomitants. Journal of Nervous and Mental Disease 1987;175(4):208‐12.

Kobayashi 1996 {published data only}

Kobayashi M. Sleep apnea of an 11‐month old infant treated with adenotomy. Otolaryngology ‐ Health and Neck Surgery (Tokyo) 1996;68(2):134‐7.

Kosho 1995 {published data only}

Kosko JR, Derkay CS. Uvulopalatopharyngoplasty: treatment of obstructive sleep apnea in neurologically impaired pediatric patients. International Journal of Pediatric Otorhinolaryngology 1995;32(3):241‐6.

Kotecha 2007 {published data only}

Kotecha B, Khalil H. A prospective randomised clinical trial: laser assisted uvulopalatoplasty versus celon radiofrequency procut palatoplasty for snoring and obstructive sleep apnoea. European Archives of Oto‐Rhino‐Laryngology and Head & Neck 2007;264(Suppl 1):S67.

Krespi 1994 {published data only}

Krespi YP, Keidar A, Khosh MM. The efficacy of laser‐assisted uvulopalatoplasty (LAUP) in the management of obstructive sleep apnea syndrome (OSA) and upper airway resistance syndrome (UARS). Head & Neck Surgery 1994;5:235‐43.

Krieger 1988 {published data only}

Krieger J, Kurtz D. The treatment of sleep apnea syndromes (SAS). Praxis und Klinik der Pneumolgie 1988;42(Suppl 1):396‐9.

L'Estrange 1995 {published data only}

L'Estrange PR, Battagel JM, Nolan PJ, Harkness B, Jorgensen GI. The importance of a multidisciplinary approach to the assessment of patients with obstructive sleep apnea. Journal of Oral Rehabilitation 1995;22(8):607‐12.

Lacahanas 2005 {published data only}

Lachanas VA, Prokopakis EP, Bourolias CA, Karatzanis AD, Malandrakis SG, Helidonis ES, et al. Ligasure versus cold knife tonsillectomy. Laryngoscope 2005;115(9):1591‐4.

Larsson 1994 {published data only}

Larsson LH, Carlsson Norlander B, Svanborg E. Four‐year follow‐up after uvulopalatopharyngoplasty in 50 unselected patients with obstructive sleep apnea syndrome. Laryngoscope 1994;104(11 I):1362‐8.

Leiter 1996 {published data only}

Leiter JC. Upper airway shape. Is it important in the pathogenesis of obstructive sleep apnea?. American Journal of Respiratory and Critical Care Medicine 1996;153(3):894‐8.

Liistro 1995 {published data only}

Liistro G, Aubert G, Rodenstein DO. Management of sleep apnoea syndrome [Review]. European Respiratory Journal 1995;8(10):1751‐5.

Loui 1994 {published data only}

Loui WS, Blackshear JL, Fredrickson PA, Kaplan J. Obstructive sleep apnea manifesting as suspected angina: report of three cases. Mayo Clinic Proceedings 1994;69:244‐8.

Lu 1995 {published data only}

Lu S, Chang S, Shiao G. Comparison between short‐term and long‐term post‐operative evaluation of sleep apnoea after uvulopalatopharyngoplasty. Journal of Laryngology and Otology 1995;109:308‐12.

Lysdahl 2002 {published data only}

Lysdahl M, Haraldsson PO. Uvulopalatopharyngoplasty versus laser uvulopalatoplasty: prospective long‐term follow‐up of self‐reported symptoms. Acta Oto‐Laryngologica 2002;122(7):752‐7.

MacCallum 2000 {published data only}

MacCallum PL, Parnes LS, Sharpe MD, Harris C. Comparision of open, percutaneous, and translaryngeal tracheostomies. Otolaryngology‐Head and Neck Surgery 2000;122:686‐90.

Maisel 1992 {published data only}

Maisel RH, Antonelli PJ, Iber C, Mahowald M, Wilson KS, Fiedler B, et al. Uvulopalatopharyngoplasty for obstructive sleep apnea: a community's experience. Laryngoscope 1992;102(6):604‐7.

Marcus 1990 {published data only}

Marcus CL, Crockett DM, Ward SL. Evaluation of epiglottoplasty as treatment for severe laryngomalacia. Journal of Pediatrics 1990;117(5):706‐10.

Marcus 1996 {published data only}

Marcus CL, Loughlin GM. Obstructive sleep apnea in children. Seminars in Pediatric Neurology 1996;3(1):23‐8.

Marrone 1995 {published data only}

Marrone O, Salvaggio A, Insalaco G, Bonsignore MR, Cimimo M, Gallina S, et al. Respiration in NREM and REM sleep after upper airway surgery for obstructive sleep apnoea. Journal of Sleep Research 1995;4(3):189‐95.

Matsuda 1995 {published data only}

Matsuda E. A case of obstructive sleep apnea syndrome with acromegaly. Otolaryngology ‐ Head and Neck Surgery (Tokyo) 1995;67(12):1036‐40.

Mayer 1995 {published data only}

Mayer G, Hochban W, MeierEwert K. Differential therapeutic aspects in the treatment of obstructive sleep apnea syndrome. Nervenarzt 1995;66(4):293‐8.

McGuirt 1995 {published data only}

McGuirt WF, Johnson JT, Sanders MH. Previous tonsillectomy as prognostic indicator for success of uvulopalatopharyngoplasty. Laryngoscope 1995;105(11):1253‐5.

Mickelson 1996 {published data only}

Mickelson SA. Laser‐assisted uvulopalatoplasty for obstructive sleep apnea. Laryngoscope 1996;106:10‐13.

Miljeteig 1992 {published data only}

Miljeteig H, Tvinnereim M. Uvulopalatopharyngoglossoplasty (UPPGP) in the treatment of obstructive sleep apnea syndrome. Acta Oto‐laryngologica 1992;492(Suppl):86‐9.

Min 1995 {published data only}

Min YG, Kang MK, Park HM, Song BH. Effects of adenotonsillar hypertrophy on snoring in children. ORL; Journal for oto‐rhino‐laryngology and its related specialties 1995;57(4):214‐9.

Minarikova 1995 {published data only}

Minarikova E, Profant M, Drugda B, Hronec J, Ruzicka J. Changes of polysomnographic parameters in patients with obstructive sleep apnea syndrome before and after uvulopalatopharyngoplasty. Studia Pneumologica at Phtiseologica 1995;55(5):367‐71.

Mintz 1995 {published data only}

Mintz SM, Ettinger AC, Geist JR, Geist RY. A modified geniotomy technique for obstructive sleep apnea syndrome. Journal of Oral & Maxillofacial Surgery 1995;53(10):1226‐8.

Miyazaki 1989 {published data only}

Miyazaki S, Itasaka Y, Yamakawa K, Okawa M, Togawa K. Respiratory disturbance during sleep due to adenoid‐tonsillar hypertrophy. American Journal of Otolaryngology 1989;10(2):143‐9.

Mochizuki 1996 {published data only}

Mochizuki T. Clinical problems in uvulopalatopharyngoplasty. Otalaryngology ‐ Head and Neck Surgery 1996;68(5):399‐403.

Mochizuki 1996a {published data only}

Mochizuki T, Okamoto M, Sano H, Naganuma H. Cephalometric analysis in patients with obstructive sleep apnea syndrome. Acta Oto‐Laryngologica 1996;524(Suppl):64‐72.

Mondain 1994 {published data only}

Mondain M, Dejean Y, Crampette L. Pharyngoplasty and velar function in snoring surgical treatment. Journal Francais d'Oto‐Rhino‐Laryngologie 1994;43(6):429‐31.

Morin 1994 {published data only}

Morin CM, Culbert JP, Schwartz SM. Nonpharmacological interventions for insomnia: a meta‐analysis of treatment efficacy. The American Journal of Psychiatry 1994;151(8):1172‐80.

Murakami 2002 {published data only}

Murakami N, Hara H, Yamashita H. A clinical study of sleep apnea syndrome. Japanese Journal of Otolaryngology of Japan 2002;105(11):1116‐20.

Nakai 1995 {published data only}

Nakai K. The influence of pharyngoplasty on articulation. Journal of the Oto‐Rhino‐Laryngological Society of Japan 1995;98(3):442‐56.

Nimkarn 1995 {published data only}

Nimkarn Y, Miles PG, Waite PD. Maxillomandibular advancement surgery in obstructive sleep apnea syndrom patients: Long‐term surgical stability. Journal of Oral and Maxillofacial Surgery 1995;53:1414‐8.

Nishimura 1996 {published data only}

Nishimura T, Morishima N, Hasegawa S, Shibata N, Iwanaga K, Yagisawa M. Effect of surgery of obstructive sleep apnea. Acta Oto‐Laryngologica 1996;523(Suppl):231‐3.

Noseda 1996 {published data only}

Noseda A, Kempanaers C, Kerkhofs M, Houben JJ, Linkowski P. Sleep apnea after 1 year domiciliary nasal‐continuous positive airway pressure and attempted weight reduction: Potential for weaning from continuous positive airway pressure. Chest 1996;109(1):138‐43.

Ohta 1993 {published data only}

Hishakawa Y, Togawa K, Katayama S, Okada T, et al. Sleep‐disordered breathing in Japan: An overview. Japanese Journal of Thoracic Diseases 1993;31(S):12‐8.

Paaske 1994 {published data only}

Paaske PB, Rasmussen BM, Illum P. Fusobacterium pneumonia and death following uvulo‐palato‐pharyngoplasty. Head and Neck 1994;16(5):450‐2.

Pack 1994 {published data only}

Pack AI. Obstructive Sleep Apnea. Advances in Internal Medicine 1994;39:517‐67.

Partinen 1988 {published data only}

Partinen M, Jamieson A, Guilleminault C. Long‐term outcome for obstructive sleep apnoea syndrome patients. Mortality. Chest 1988;94:1200‐4.

Partinen 1990 {published data only}

Partinen M, Guilleminault C. Daytime sleepiness and vascular morbidity at seven‐year follow‐up in obstructive sleep apnea patients. Chest 1990;97(1):27‐32.

Partinen 1996 {published data only}

Partinen M, Telakivi T. Epidemiology of obstructive sleep apnea syndrome. Sleep 1996;15:S1‐4.

Penek 1995 {published data only}

Penek J. Laser‐assisted uvulopalatoplasty: the cart before the horse. Chest 1995;107(1):1‐3.

Peng 1995 {published data only}

Peng P, Wang Z, Zhang L. Uvulopalatopharyngoplasty: safety managements and causes of failure. Chinese Journal of Otorhinolaryngology 1995;30(3):135‐7.

Peter 1995 {published data only}

Peter JH, Koeler U, Grote L, Podszus T. Manifestations and consequences of obstructive sleep apnoea. European Respiratory Journal 1995;8:1572‐83.

Piper 1995 {published data only}

Piper JG, Dirks BA, Traynelis VC, VanGilder JC. Perioperative management and surgical outcome of the acromegalic patient with sleep apnea. Neurosurgery 1995;36(1):70‐4.

Polo 1994 {published data only}

Polo O, Berthon‐Jones M, Douglas NJ, Sullivan CE. Management of obstructive sleep apnoea / hypopnoea syndrome. Lancet 1994;344:656‐60.

Pories 1995 {published data only}

Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, et al. Who would have thought it? An operation proves to be the most effective therapy for adult‐onset diabetes mellitus. Annals of Surgery 1995;222(3):339‐52.

Potsic 1987 {published data only}

Potsic WP. Comparison of polysomnography and sonography for assessing regularity of respiration during sleep in adenotonsillar hypertrophy. Laryngoscope 1987;97(12):1430‐7.

Prinz 1995 {published data only}

Prinz PN. Sleep and sleep disorders in older adults. Journal of Clinical Neurophysiology 1995;12(2):139‐46.

Pulido 1995 {published data only}

Pulido Cobo MD, Quintero Otero S, Hernandez Gonzalez A, Rubio Quinones F, Marin Ferrer M, Martin A, et al. Emergency tonsillectomy for obstructive sleep apnea syndrome in childhood. Revista Espanola de Pediatria 1995;51(305):462‐6.

Quinn 1995 {published data only}

Quinn SJ, Daly N, Ellis PD. Observation of the mechanism of snoring using sleep nasendoscopy. Clinical Otolaryngology 1995;20(4):360‐4.

Rapoport 1986 {published data only}

Rapoport dM, Garay SM, Epstein H, Goldring RM. Hypercapnia in the obstructive sleep apnea syndrome: a re‐evaluation of the "Pickwickian syndrome". Chest 1986;89(5):627‐35.

Reimao 1985 {published data only}

Reimao R, Lemmi H, Akiskal H, Cocke E. Polysomnographic follow‐up of sleep apneas after uvulopalatopharyngoplasty. Arquivos de Neuro‐Psiquiatria 1985;43(4):360‐4.

Reimao 1986 {published data only}

Reimao R, Lemmi H, Akiskal H. Obstructive sleep apnea treated with uvulopalatopharyngoplasty: a systematic follow‐up study. Southern Medical Journal 1986;79(9):1064‐6.

Riley 1989 {published data only}

Riley RW, Powell NB, Guilleminault C. Inferior sagittal osteotomy of the mandible with hyoid myotomy suspension: a new procedure for Obstructive Sleep Apnea. Otolaryngology ‐ Head & Neck Surgery 1989;94:589‐93.

Riley 1990 {published data only}

Riley RW, Powell NB. Maxillofacial surgery and obstructive sleep apnea syndrome. Otolaryngologic Clinics of North America 1990;23(4):809‐26.

Riley 1990a {published data only}

Riley RW, Powell NB, Guilleminault C. Maxillofacial surgery and nasal CPAP. A comparison of treatment for obstructive sleep apnoea. Chest 1990;98(6):1421‐5.

Riley 1994 {published data only}

Riley RW, Powell NB, Guilleminault C. Obstructive sleep apnea and the hyoid: A revised surgical procedure. Otolaryngology‐ Head & Neck Surgery 1994;111(6):717‐21.

Riley 1995 {published data only}

Riley RW, Powell NB, Guilleminault C, Clerk A, Troell R. Obstructive sleep apnea. Trends in therapy. Western Journal of Medicine 1995;162(2):143‐8.

Rodenstein 1992 {published data only}

Rodenstein DO. Assessment of uvulopalatopharyngoplasty for the treatment of sleep apnea syndrome. Sleep 1992;15:S56‐S62.

Rodenstein 1995 {published data only}

Rodenstein D, Collard P, Aubert G, Fleetham JA. OSA treatment UPPP vs N‐CPAP. Chest 1995;107(2):584‐5.

Rodrigues 2002 {published data only}

Rodrigues Thuler E, Silveira Dibern R, Fomin DS, De Oliveira JAA. Laser‐assisted uvulopalatoplasty ‐ Comparative analisys of the clinical improvement and the indication criteria. Revista Brasileira De Otorrinolaringologia 2002;68(2):190‐3.

Rothschild 1995 {published data only}

Rothschild MA, Catalino P, Biller HF. Ambulatory pediatric tonsillectomy and the identification of high‐risk subgroups. Otolaryngology‐ Head & Neck Surgery 1994;110(2):203‐10.

Sangal 1992 {published data only}

Sangal RB, Thomas L, Mitler MM. Disorders of excessive sleepiness. Treatment improves ability to stay awake but does not reduce sleepiness. Chest 1992;102(3):699‐703.

Schechtman 1995 {published data only}

Schechtman KB, Sher AE, Piccirillo JF. Methodological and statistical problems in sleep apnea research: the literature on uvulopalatopharyngoplasty. Sleep 1995;18(8):659‐66.

SchultzCoulon 1996 {published data only}

SchulzCoulon HJ, Misgeld G. Otorhinolaryngological aspects of snoring. Atemwegs‐ und Lungenkrankheiten 1996;22(4):202‐7.

Schwartz 1992 {published data only}

Schwartz AR, Schubert N, Rothman W, Godley F, Marsh B, Eisele D, et al. Effect of uvulopalatopharyngoplasty on upper airway collapsibility in obstructive sleep apnea. American Review of Respiratory Disease 1992;145(3):527‐32.

Sdralis 1996 {published data only}

Sdralis T, Berkowitz RG. Early adenotonsillectomy for relief of acute upper airway obstruction due to acute tonsillitis in children. International Journal of Pediatric Otorhinolaryngology 1996;35(1):25‐9.

Semple 1993 {published data only}

Semple SJ, Gibson GJ, Burney PG, et al. Sleep apnoea and related conditions, with recommendations for service provision. Royal College of Physicians, London1993.

Series 1992 {published data only}

Series F, St. Pierre S, Carrier G. Effects of surgical correction of nasal obstruction in the treatment of obstructive sleep apnea. American Review of Respiratory Disease 1992;146:1261‐5.

Sher 1985 {published data only}

Sher AE, Thorpy MJ, Shprintsen RJ, Spielman AJ, Burack B, McGregor PA. Predictive value of Muller manoeuver in selection of patients for uvulopalatopharyngoplasty. Laryngoscope 1985;92(12):1483‐7.

Sher 1995 {published data only}

Sher AE. Treating obstructive sleep apnea syndrome ‐ a complex task. Western Journal of Medicine 1995;162(2):170‐2.

Sher 1996 {published data only}

Sher AE. When is upper airway surgery appropriate for obstructive sleep apnea?. Clinical Pulmonary Medicine 1996;3(2):78‐85.

Sher et al 1996 {published data only}

Sher AE, Schechman KB, Piccirillo JF. The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 1996;19(2):156‐77.

Simmons 1984 {published data only}

Simmons FB, Guilleminault C, Miles LE. The palatopharyngoplasty operation for snoring and sleep apnea: an interim report. Otolaryngology‐ Head & Neck Surgery 1984;92(4):375‐80.

Simonds 1994 {published data only}

Simonds AK. Sleep studies of respiratory function and home respiratory support. BMJ 1994;309:15‐40.

Skatvedt 1995 {published data only}

Skatvedt O. Continuous pressure measurements during sleep to localize obstructions in the upper airways in heavy snores and patients with obstructive sleep apnea syndrome. European Archives of Oto‐Rhino‐Laryngology 1995;252(1):11‐4.

Stradling 1990 {published data only}

Stradling JR, Crosby JH. Relation between systemic hypertension and sleep hypoxaemia or snoring: analysis in 748 men drawn from general practice. BMJ 1990;300:75‐8.

Stradling 1990a {published data only}

Stradling JR, Thomas G, Warley AR, Williams P, Freeland A. Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance, and symptoms in snoring children. Lancet 1990;335:249‐53.

Stradling 1995 {published data only}

Stradling JR. Commentary: Upper airways dysfunction. Thorax 1995;50(6):696‐7.

Strollo 1996 {published data only}

Strollo PJ, Rogers RM. Obstructive sleep apnea. New England Journal of Medicine 1996;334(2):99‐104.

Suen 1995 {published data only}

Suen JS, Arnold JE, Brooks LJ. Adenotonsillectomy for treatment of obstructive sleep apnea in children. Archives of Otolaryngology ‐Head & Neck Surgery 1995;121(5):525‐30.

Sugerman 1986 {published data only}

Sugerman HJ, Fairman RP, Baron PL, Kwentus JA. Gastric surgery for respiratory insufficiency of obesity. Chest 1986;90(1):81‐6.

Sullivan 1985 {published data only}

Sullivan CE, Issa FG. Obstructive sleep apnea. Clinics in Chest Medicine 1985;6:633‐50.

Tangugsorn 1995 {published data only}

Tangugsorn V, Skatvedt O, Krogstad O, Lyberg T. Obstructive sleep apnoea: a cephalometric study. Part I. Cervico‐craniofacial skeletal morphology. European Journal of Orthodontics 1995;17(1):45‐56.

Tangugsorn 1995a {published data only}

Tangugsorn V, Skatvedt O, Krogstad O, Lyberg T. Obstructive sleep apnoea: a cephalometric study. Part II. Uvulo‐glossopharyngeal morphology. European Journal of Orthodontics 1995;17(1):57‐67.

Terris 1996 {published data only}

Terris DJ, Clerk AA, Norbash AM, Troell RJ. Characterization of postoperative edema following laser‐assisted uvulopalatoplasty using MRI and polysomnography: implications for the outpatient treatment of obstructive sleep apnea syndrome. Laryngoscope 1996;106(2 Pt 1):124‐8.

Terris 2002 {published data only}

Terris DJ, Coker JF, Thomas AJ, Chavoya M. Preliminary findings from a prospective, randomized trial of two palatal operations for sleep‐disordered breathing. Otolaryngology‐ Head & Neck Surgery 2002;127(4):315‐23.

Thalhofer 1995 {published data only}

Thalhofer S, Dorow P, Jahnke V, Kuuhler U, Meissner P. Polysomnographical results before and after uvulo‐palato‐pharyngo‐plasty (UPPP). Pneumologie 1995;49(S1):180‐2.

Thorpy 1994 {published data only}

Thorpy M, Chesson A, Derderian S, Kader G, Millman R, Potolicchio S, et al. Practice parameters for the use of laser‐assisted uvulopalatoplasty. Sleep 1994;17(8):744‐8.

Troell 2000 {published data only}

Troell RJ, Powell NB, Riley RW, Li KK. Comparison of postoperative pain between laster‐assisted uvulopalatoplasty, uvulopalatopharyngoplasty, and radiofrequency volumetric tissue reduction of the palate. Otolaryngoplasty ‐ Head and Neck Surgery 2000;122(3):402‐9.

Truy 1995 {published data only}

Truy E. Effectiveness of musculus palatopharyngeus resection in uvulopalatopharyngoplasty for snoring. Journal of Otolaryngology 1995;24(2):79‐84.

Verse 2002 {published data only}

Verse T, Maurer JT, Pirsig W. Effect of nasal surgery on sleep‐related breathing disorders. Laryngoscope 2002;112(1):64‐8.

Wakeing 1996 {published data only}

Wakeing M, Mitchell D. Laser‐assisted uvulopalatoplasty: An assessment of a technique. Journal of Laryngology & Otology 1996;110(3):232‐6.

Waldhorn 1990 {published data only}

Waldhorn RE, Herrick TW, Nguyen MC, O'Donnell AE, Sodero J, Potolicchio SJ. Long‐term compliance with nasal continuous positive airway pressure therapy of obstructive sleep apnea. Chest 1990;97(1):33‐8.

Walker 1989 {published data only}

Walker EB, Frith RW, Harding DA, Cant BR. Uvulopalatopharyngoplasty in severe idiopathic obstructive sleep apnoea syndrome. Thorax 1989;44:205‐8.

Walker 1995 {published data only}

Walker RP, Grigg‐Damberger MM, Gopalsami C, Totten MC. Laser‐assisted uvulopalatoplasty for snoring and obstructive sleep apnea: results in 170 patients. Laryngoscope 1995;105(9 Pt 1):938‐43.

Weiss 1995 {published data only}

Weiss DD. Middle section meeting, triological society. Archives of Otolarngology ‐ Head and Neck Surgery 1995;121(7):810‐1.

Wetmore 1986 {published data only}

Wetmore SJ, Scrima L, Snyderman NL, Hiller FC. Postoperative evaluation of sleep apnea after uvulopalatopharyngoplasty. Laryngoscope 1986;96:738‐41.

Wiltfang 1996 {published data only}

Wiltfang J, Merten HA, Luhr HG. The functional palatorrhaphy in the treatment of obstructive sleep apnea. British Journal of Oral and Maxillofacial Surgery 1996;34(1):82‐6.

Woodson 1994 {published data only}

Woodson BT, Wooten MR. Manometric and endoscopic localization of airway obstruction after uvulopalatopharyngoplasty. Otolaryngology ‐ Head and Neck Surgery 1994;111(1):38‐43.

Woodson 1996 {published data only}

Woodson BT. Upper airway resistance syndrome after uvulopalatopharyngoplasty for obstructive sleep apnea syndrome. Otolaryngology ‐ Head and Neck Surgery 1996;114(3):457‐61.

Wright 1995 {published data only}

Wright J, Dye R. Systematic review on obstructive sleep apnoea: it's effect on health and benefit of treatment. Vol. 60, Leeds: Nuffield Institute for Health, Yorkshire Collaborating Centre for Health Services Research, 1995.

Yamadera 1994 {published data only}

Yamadera W. Psychophysiological and psychological consequences after surgical treatment of obstructive sleep apnea syndromes. Psychiatria e Neurologia Japonica 1994;96(10):903‐32.

Yamadera 1995 {published data only}

Yamadera W. Improvement in excessive daytime sleepiness after surgical treatment for obstructive sleep apnea syndrome. Psychiatry and Clinical Neursciences 1995;49(4):213‐21.

Yoder 1995 {published data only}

Yoder KM. Sleep apnea... a serious disorder. Access 1995;9(7):32‐6.

Zohar 1993 {published data only}

Zohar Y, Finkelstein Y, Strauss M, Shvilli Y. Surgical treatment of obstructive sleep apnea: Technical variations. Archives of Otolarngology ‐ Head and Neck Surgery 1993;119(9):1023‐9.

Zorick 1983 {published data only}

Zorick FJ, Roehrs T, Conway WA, Fujita S, Wittig R, Roth T. Effects of uvulopalatopharyngoplasty on the daytime sleepiness associated with sleep apnea syndrome. Bulletin Europeen de Physiopathologie Respiratoire 1983;19:600‐3.

Zorick 1989 {published data only}

Zorick FJ, Potts G, Wittig R, Roehrs TA, Rosenthal LD, Roth T. A comparative trial of CPAP and UPPP in alleviating daytime sleepiness in sleep apnea patients. Sleep Research 1989;18:325.

Zorick 1990 {published data only}

Zorick FJ, Roehrs T, Conway WA, Potts G, Roth T. Response to CPAP and UPPP in apnea. Henry Ford Hospital Medical Journal 1990;38(4):223‐6.

Referencias de los estudios en espera de evaluación

Ir a:

Lin 2002 {published data only}

Lin Z, Wang T, Fan X. Continuous positive airway pressure therapy after uvulopalatopharygoplasty. Chung Hua Erh Pi Yen Hou Ko Tsa Chih ‐ Chinese Journal of Otorhinolaryngology 1999;34(2):100‐2.

Tommi 2004 {unpublished data only}

Tommi L, Antti M, Maskku P, Jukka Y, Leif B. Radiofrequency induced thermo‐therapy of the soft palate as the treatment of mild sleep apnea syndrome. A prospective placebo‐controlled randomized study. 5th Eurpoean Congress of Oto‐rhino‐laryngology, Head and Neck surgery. 2004:Abstract P261.

Aboussouan 1995

Aboussouan LS, Golish JA, Wood BG, Mehta AC, Wood DE, Dinner DS. Dynamic pharyngoscopy in predicting outcome of uvulopalatopharyngoplasty for moderate and severe obstructive sleep apnea. Chest 1995;107(4):946‐51.

Bresnitz 1994

Bresnitz EA, Goldberg R, Koxfsinski RM. Epidemiology of obstructive sleep apnea. Epidemiologic Reviews 1994;16:210‐27.

Eveloff 1994

Eveloff SE, Rosenberg CL, Carlisle CC, Millman RP. Efficacy of a herbst mandibular advancement device in obstructive sleep apnea. American Journal of Respiratory & Critical Care Medicine 1994;149:905‐9.

Ferguson 1995

Ferguson KA, Fleetham JA. Consequences of sleep disordered breathing. Thorax 1995;50:998‐1004.

Findley 1988

Findley LJ, Unverzagt ME, Suratt PM. Automobile accidents involving patients with obstructive sleep apnoea. American Review of Respiratory Disease 1988;138:337‐40.

Giles 2006

Giles TL, Lasserson TJ, Smith BJ, White J, Wright J, Cates CJ. Continuous positive airways pressure for obstructive sleep apnoea (Cochrane review). Cochrane Database of Systematic Reviews 2006, Issue 3. [DOI: 10.1002/14651858.CD001106.pub3.]

Gould 1988

Gould GA, Whyte KF, Rhind GB, et al. The sleep hypopnea syndrome. American Review of Respiratory Disease 1988;137:895‐98.

Guilleminault 1993

Guilleminault C, Stoohs R, Clerk A, Cetel M, Maistros P. A cause of excessive daytime sleepiness. The upper airways resistance syndrome. Chest 1993;104(3):781‐7.

Handbook

Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0 [updated February 2008]. Available from www.cochrane‐handbook.org. The Cochrane Collaboration, 2008.

Haniffa 2004

Haniffa M, Lasserson TJ, Smith I. Interventions to improve compliance with continuous positive airway pressure for obstructive sleep apnoea (Cochrane review). Cochrane Database of Systematic Reviews 2004, Issue 4. [DOI: 10.1002/14651858.CD003531.pub2.]

Isono 1995

Isono S, Tanaka A, Sho Y, Konno A, Nishino T. Advancement of the mandible improves velopharyngeal airway patency. Journal of Applied Physiology 1995;79(6):2132‐8.

Jadad 1996

Jadad AR, Moore A, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomised clinical trials: Is blinding necessary?. Controlled Clinical Trials 1996;17:1‐12.

Jennum 1992

Jennum P, Sjøl A. Epidemiology of snoring and Obstructive Sleep Apnoea in a Danish population aged 30‐60. Journal of Sleep Research 1992;1:240‐4.

Lim 2006

Lim J, Lasserson TJ, Fleetham J, Wright J. Oral appliances for obstructive sleep apnoea (Cochrane review). Cochrane Database of Systematic Reviews 2006, Issue 1. [DOI: 10.1002/14651858.CD004435.pub3.]

Masdon 2004

Masdon JL, Magnuson S, Yougblood G. The effects of upper airway surgery for obstructive sleep apnea on nasal continuous positive airway pressure settings. The Laryngoscope 2004;114:205‐7.

McNicholas 1996

McNicholas WT. Diagnostic criteria for the sleep apnoea syndrome: Time for consensus?. European Respiratory Journal 1996;9(4):634‐5.

Mooe 2001

Mooe T, Franklin KA, Holmstrom K, Rabben T, Wiklund U. Sleep‐disordered breathing and coronary artery disease: long‐term prognosis. American Journal of Respiratory & Critcal Care Medicine 2001;164(10):1910‐3.

Mortimore 1996

Mortimore IL, Bradley PA, Murray JA, Douglas NJ. Uvulopalatopharyngoplasty may compromise nasal CPAP therapy in sleep apnea syndrome. American Journal of Respiratory & Critical Care Medicine 1996;154(6):1759‐62.

Petri 1994

Petri N, Suadicani P, Wildschiodtz G, BjornJorgensen J. Predictive value of Muller Manoeuver, cephalometry and clinical features for the outcome of uvulopalatopharyngoplasty. Evaluation of predictive factors using discriminant analysis in 30 sleep apnea patients. Acta Oto‐Laryngologica 1994;114(5):565‐71.

Potsic 1989

Potsic WP. Obstructive sleep apnea. Pediatric Clinics of North America 1989;36(6):1435‐42.

RCP 1993

Royal College of Physicians. Sleep Apnoea and related conditions: with recommendations for service provision. Royal College of Physicians of London1993.

SIGN 2003

Scottish Intercollegiate Guideline Network. Management of obstructive sleep apnoea/hypopnoea syndrome in adults (Guideline no. 73). http://www.sign.ac.uk[Accessed July 2005].

Stradling 1995a

Stradling JR. Obstructive sleep apnoea: definitions, epidemiology, and natural history. Thorax 1995;50:683‐9.

Taylor 1995

Taylor JF (Ed). Medical aspects of fitness to drive: a guide for medical practitioners. London: Medical Commission on Accident Prevention, 1995.

Weaver 2004

Weaver EM, Maynard C, Yueh B. Survival of veterans with sleep apnea: continuous positive airway pressure versus surgery. Otolaryngoplasty ‐ Head and Neck Surgery 2004;130(6):659‐65.

Weaver 2005

Weaver EM, Woodson BT, Steward DL. Polysomnography indexes are discordant with quality of life, symptoms, and reaction times in sleep apnea patients. Otolaryngology ‐ Head & Neck Surgery 2005;132(2):255‐62.

Wright 1997

Wright J, Johns R, Watt I, Melville A, Sheldon T. Health effects of obstructive sleep apnoea and the effectiveness of continuous positive pressure: a systematic review of the research evidence. BMJ 1997;314:851‐60.

Young 1993

Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep disordered breathing among middle aged adults. New England Journal of Medicine 1993;328:1230‐5.

Zohar 1991

Zohar Y, Finkelstein Y, Talmi YP, Bar‐Ilan Y. Uvulopalatopharyngoplasty: evaluation of postoperative complications, sequelae, and results. Laryngoscope 1991;101:775‐9.

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Ir a:

Atef 2005

Methods

Randomised, parallel group trial. Method of randomisation not reported; participants also randomised within each treatment group to between 1‐5 sessions of treatment. Blinding not reported. Loss to follow‐up: LAUP: 13; BRVTR: 11)

Participants

N = 150. No data were provided on gender. Mean age: 47. Mean AHI for treatment groups at baseline: 25‐27. Participants suffered from mild to moderate OSA.

Inclusion criteria: AHI between 5‐30; OSA obstruction mainly at the palate site; refusal of other treatment options (CPAP, conservative management (including weight‐loss) and oral appliances)

Exclusion criteria: BMI >30kg/m2; simple snoring, OSA due to nasal or retrolingual obstruction; large obstructing tonsils; prior palate surgery.

Interventions

LAUP versus BRVTR. Follow‐up conducted at 3 and 18 months post‐operatively. Participants randomly assigned within each treatment group to between one and five treatment sessions.

Outcomes

AHI; symptoms (measured on visual analogue scale
e); withdrawal

Notes

Jadad score: 2

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias in generating randomisation sequence. Participants randomly assigned within each treatment group to between one and five treatment sessions.

Allocation concealment (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias of investigators being aware of order of treatment group assignment

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Information not available

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Information not available
Bassiouny 2007

Methods

Randomised, parallel group trial. Method of randomisation not reported. Single‐blind study.

Participants

N = 40 AHI: Unclear. BMI: 28

Inclusion criteria: Snoring due to palatal redundancy and/or excessive
lengthening; AHI 10 ‐ 30; O2 saturation >85%.

Exclusion criteria: Snoring/OSA due causes other than palatal redundancy and/or excessive lengthening (such as tonsillar hypertrophy, tongue base hypertrophy or lateral pharyngeal walls redundancy); Simple snoring (AHI < 10 events per hour); Severe OSA (AHI > 30 events per hour); Morbid obesity, body mass index >30.

Interventions

RAUP versus RCT. Follow‐up conducted over 4 months.

Outcomes

Pain; snoring score; dysphagia

Notes

Jadad score: 1

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias in generating randomisation sequence.

Allocation concealment (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias of investigators being aware of order of treatment group assignment

Blinding (performance bias and detection bias)
All outcomes

High risk

Single‐blind study.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Information not available
Cahali 2004

Methods

Randomised, parallel group trial. Method of randomisation not reported (stratified for severity of AHI); blinding not undertaken.

Participants

N = 29. No data were provided on gender or mean age. Two withdrawals from UPPP group. Mean BMI: Lateral PP: 29.3; UPPP: 30.1; median ESS: 14

Inclusion criteria: low lying soft palate associated with fibreoptic pharyngoscopic finding of narrowing/collapse in retropalatal region without narrowing in hypopharynx (at rest and during Muller maneuver); >18 years; AHI >/= 10; failure to tolerate CPAP; failure to achieve significant weight loss in overweight participants; all participants chosen on basis of subjective finding of bulky lateral oropharyngeal tissues

Exclusion criteria: >130kg in weight; morbid obesity; hypothyroidism (uncontrolled or present <12 m); gross maxillary/mandible deformities.

Interventions

UPPP versus lateral PP. Follow‐up conducted at least 6 months after operation (range: 7‐12 months)

Outcomes

AHI; ESS; neck circumference; BMI; Time taken to return to normal nutrition; QoL

Notes

Jadad score: 2

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias in generating randomisation sequence. Stratified for severity of AHI.

Allocation concealment (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias of investigators being aware of order of treatment group assignment

Blinding (performance bias and detection bias)
All outcomes

High risk

Open label assessment

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Information not available
Ferguson 2003

Methods

Randomised parallel group trial. Method of randomisation: Random numbers table. Blinding to treatment was not attempted.

Participants

N = 46. 35M; LAUP: 21; No treatment: 24 (one withdrawal after randomisation).
Mean age: 44.6 (SD 8.1); BMI 36 (SD 4.5)

AHI: LAUP: 18.6 (SD 4.3); Control 16.1 (SD 4); ESS: LAUP: 10.7 (SD 3.7); Control: 10 (SD 5.2)

One participant in each group had previously had CPAP.

Inclusion criteria: AHI: 10‐25; complaint of 'loud snoring'

Interventions

Laser‐assisted UPP in an outpatient setting. Participants in the control group had no treatment. LAUP was repeated in the treatment group until either snoring was reduced, no further tissue could be removed, or surgery was refused.

Surgery was repeated at 1‐2 month intervals.

Control group were offered surgery after 6 months

Outcomes

AHI; ESS; SAQLI; Snoring intensity/frequency (assessed by bed partner); Side effects and complications

Notes

Jadad score: 3

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Random numbers table

Allocation concealment (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias of investigators being aware of order of treatment group assignment

Blinding (performance bias and detection bias)
All outcomes

High risk

Surgery compared with usual care.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

One withdrawal after randomisation (low attrition rate).
Friedman 2008

Methods

Randomised parallel group trial.

Participants

N = 62. 33M. Palatal implants: 31; placebo: 31. BMI: 29; AHI: 22

Inclusion criteria: History of OSAHS and/or symptoms of OSAHS (mainly snoring & excessive daytime sleepiness); Friedman tongue position (FTP) I, II, or III; diagnosis of mild or moderate OSAHS (apnea/hypopnea index
(AHI) 5 and 40); a soft palate 2 cm, but less than 3.5 cm; BMI 32.

Exclusion criteria: Clinical and physiological presentation of severe OSAHS (ESS 20, frequent choking and gasping during sleep; OSAHS (AHI 40)); unwilling to be randomly assigned to placebo; FTP IV; tonsil size 3 or 4; classified stage IV of Friedman staging system.

Interventions

Surgically inserted palatal implants versus sham procedure (active and placebo implants were indistinguishable).

Outcomes assessed 12 weeks post‐operatively.

Outcomes

AHI; AI; Min SaO2; ESS; Quality of life (SF‐36); loss to follow‐up; complications

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

'Block randomization (blocks of 6) was performed by the manufacturer...'

Allocation concealment (selection bias)

Low risk

'...patients were assigned to groups before the procedure by sequential sealed envelopes with device lot numbers to be used for each patient. The lot numbers that corresponded to group assignments were not revealed until after the study was completed.'

Blinding (performance bias and detection bias)
All outcomes

Low risk

'The palatal implant insertion tools provided by the manufacturer for the placebo control group did not include the palatal implants, but they were in all other aspects identical to the implant insertion tools used in the treatment group receiving the implant. Group assignment associated with insertion tools was not distinguishable by study participants and investigators because the implants are deployed from within the hollow needle of a delivery tool.'

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

'An intent‐to‐treat analysis looking at objective surgical success was performed on all 62 patients who received initial study treatment (31 patients in each group). The seven patients who were lost to follow‐up were considered treatment failures and analyzed accordingly.' Data on AHI & ESS presented for remaining participants.

Larrosa 2004

Methods

Randomised parallel group study. Method of randomisation: random numbers table. Single‐blind comparison.

Participants

N = 28 adults with mild OSA and non‐apneic snorers. Three withdrawals after randomisation. AHI Surgery: 13.6; control: 17; ESS: Surgery: 10.4; control: 10.9.

Inclusion criteria: AHI </=30; age: 30‐60 years

Exclusion criteria: Snoring not due to palatal flutter (e.g. tongue base collapse/collapse of other soft tissues)

Interventions

Laser‐assisted UPP versus sham procedure. Assessment at 3 months.

Outcomes

AHI; ESS; QoL (SF‐36); snoring indices.

Notes

Mixed population study. No data have been entered in the review. Request for additional data made 080705.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Random numbers table

Allocation concealment (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias of investigators being aware of order of treatment group assignment

Blinding (performance bias and detection bias)
All outcomes

High risk

Single‐blind study

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Information not available
Lojander 1996

Methods

Randomised parallel group rial. Not blinded. Participants randomised to either CPAP versus conservative management or to surgery versus conservative management. Method of randomisation not reported

Participants

N = 32 adults with moderate to severe OSAS. Diagnosis confirmed by sleep study. Age range 27‐65, BMI: 24‐41, ODI4 in CPAP: 10‐96. ODI4 in surgery group: 20‐72. Participants with more than 50% obstruction at palatal level in the Mueller's manoeuvre, and those with or without obstruction at the epiglottic level were considered appropriate for surgery.

Inclusion criteria: confirmed diagnosis of OSAS, periodic breathing pattern in both static charge sensitive bed and thermistor channels. Participants with BMI more than 40 were excluded. Patients COPD/asthma, other serious concomitant illnesses, and participants where somnolence would cause risk or incapacity to work were excluded.

Interventions

Two groups which compared either CPAP with conservative management (not specified) or surgery (UVPP) with conservative management.

Study duration: 1 year.

Outcomes

Number of nocturnal oxygen desaturation events (4% or more per hour), daytime somnolence, side effects, withdrawals.

Notes

Participants were assessed by a team of specialists (including physicians and surgeons).

Jadad score: 2

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias in generating randomisation sequence.

Allocation concealment (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias of investigators being aware of order of treatment group assignment

Blinding (performance bias and detection bias)
All outcomes

High risk

Open label assessment

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Information not available
Naya 2002

Methods

Randomised parallel group trial. Method of randomisation not reported. Blinding not specified.

Participants

N = 75 adults with ASDA defined sleep apnoea (88% M). Four treatment groups: PPR (20 participants); UPPP (Fuj): 18; UPPP (Sim): 17; UPPP (Fair): 20. Mean age: 47.7 (SD 11.2). Mean Epworth score: 12.94 (SEM 0.7).

Inclusion criteria: American Sleep Disorder Association defined OSA

Interventions

Four different surgical techniques: PPR; UPPP (Fuj); UPPP (Sim); UPPP (Fair). Study duration: 12 weeks.

Outcomes

AHI; complications

Notes

No analyses undertaken between groups.

Jadad score 1

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias in generating randomisation sequence.

Allocation concealment (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias of investigators being aware of order of treatment group assignment.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Information not available

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Information not available
Pang 2007

Methods

Randomised parallel group trial

Participants

N = 45 (UPPP: 22; ESP: 23)

AHI: 42

Inclusion criteria: People with small tonsils (tonsil size 1 and 2), body mass index (BMI) less than 30 kg/m2, and Friedman clinical stage II and III who cannot tolerate nasal continuous positive airway pressure (CPAP)
therapy or for whom CPAP therapy failed.

Interventions

Two surgical techniques were compared:

1. Expansion sphincter pharyngoplasty (ESP)

2. Uvulopalatopharyngoplasty (UPPP)

Mean follow‐up 6.5 months

Outcomes

AHI; complications

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias in generating randomisation sequence.

Allocation concealment (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias of investigators being aware of order of treatment group assignment

Blinding (performance bias and detection bias)
All outcomes

High risk

Information not available (assumed not since different procedures necessitated surgeon being aware what group participant assigned to)

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Informatio not available
Tegelberg 1999

Methods

Randomised, parallel group study. Comparison of surgery versus oral appliance.

Participants

95 male participants were recruited. Age: 20‐65, baseline AHI: 15.7‐23.3.

Inclusion criteria: AHI between 5 and 25, age between 20 and 65. Exclusion criteria: Mental illness, drug misuse, significant nasal obstruction, insufficient teeth, pronounced dental malocclusion, severe cardiovascular disease, neurological disease, respiratory disease. At 4 year follow‐up, OA group: N = 32, UPPP group: N = 40.

Interventions

Participants were randomised to either oral appliance or surgical intervention (uvulopalatopharyngoplasty). Participants randomised to receive UPP were followed up at regular intervals.

Study duration: 1 year.

Outcomes

AHI, AI, oxygen desaturation index, snoring index, clinical dysfunction score, QOL scores

Notes

Jadad score: 2

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias in generating randomisation sequence.

Allocation concealment (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias of investigators being aware of order of treatment group assignment

Blinding (performance bias and detection bias)
All outcomes

High risk

Open label assessment

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Information not available
Thomas 2003

Methods

Randomised controlled trial. Method of randomisation: computer‐generated randomisation sequence. Blinding: not reported

Participants

N = 17 adults. Tongue suspension group (TS): 50.8 (SD 16.1); Tongue advancement group (TA): AHI: TS: 46 (SD 22); TA: 37.4 (SD 15.1); BMI: TS: 30.9 (6.2); TA: 28.7 (SD 2.7)

Inclusion criteria: moderate to severe sleep disordered breathing; Fujita type II airway collapse; failure of conservative therapy (CPAP, weight loss etc); BMI <40
Exclusion criteria: prior surgical treatment; contraindications for surgical treatment

Interventions

Tongue advancement (mandibular osteotomy) + PPP versus tongue suspension + PPP. Study duration: 16 weeks

Outcomes

Epworth Sleepiness score; Airway collapse (Müller maneuver); snoring

Notes

Jadad score: 3

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer‐generated randomisation sequence

Allocation concealment (selection bias)

Unclear risk

Insufficient information presented to ascertain risk of bias of investigators being aware of order of treatment group assignment

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Information not available

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

Information not available
Woodson 2003

Methods

Randomised, single‐blinded, parallel group trial. Method of randomisation: computer generated random numbers table (allocation concealed using sealed envelopes). Withdrawals reported. Data not analysed for 8 participants who did not complete study.)

Participants

N = 90 (CPAP: 30 and TCRFTA: 30; placebo: 30); mean age: Placebo: 46; TCRFTA: 49.4; CPAP: 51.7; BMI: Placebo: 28.5; TCRFTA: 27.7; CPAP: 29.1; AHI: Placebo: 15.4; TCRFTA: 21.3; CPAP: 19.8; ESS: Placebo: 11.6; TCRFTA: 11.9; CPAP: 12.6; FOSQ: Placebo: 16.8; TCRFTA: 16.5; CPAP: 16

Inclusion criteria: mild to moderate OSA (AHI 10 to 30; age 18‐65; self‐reported daytime sleepiness; BMI </=34; no prior surgical or CPAP treatment

Exclusion criteria: co‐existing significant sleep disorder; tonsillar hypertrophy; nasal supraglottic obstruction on examination; ASA class IV/V; claustrophobia; latex allergy; pregnancy; major depression; drug/alcohol abuse; history of an accident secondary to sleepiness; participation in another study

Interventions

TCRFTA (radiofrequency energy delivered to create non‐overlapping lesions in two/three tongue sites, occurring at 4 week intervals. Data recorded after kast treatment session. Palate sessions also included) versus sham TRCFTA. Both active and sham surgical interventions were compared with nasal CPAP.

CPAP outcome data reported at 8 weeks.

Outcomes

Number of surgery sessions; CPAP machine usage; FOSQ; ESS; AHI; CPAP treatment pressure; pain/side effects; reaction times

Notes

Jadad score: 3

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Computer generated random numbers table.

Allocation concealment (selection bias)

Low risk

Allocation concealed using sealed envelopes.

Blinding (performance bias and detection bias)
All outcomes

High risk

Single blind assessment (surgery versus sham surgery); open label assessment with CPAP.

Incomplete outcome data (attrition bias)
All outcomes

High risk

Data not analysed for 8 participants who did not complete study

AHI: Apnoea hypopnea index; AI: Apnoea index; UPP: Uvulopalatoplasty; UPPP: Uvulopalatopharyngoplasty; QoL: Quality of life; Lateral PP: Lateral pharyngoplasty;OSA: Obstructive Sleep Apnoea; SDB: Sleep Disordered Breathing; ESS: Epworth Sleepiness Score; MAD: Mandibular Advancement Device; CPAP: Continuous positive airways pressure; TCRFTA: Temperature‐contreolled radiofrequency tissue ablation; PPR: Partial palatal resection; UPPP (Fuj): Uvulopalatopharyngoplasty according to Fujita; UPPP (Sim): Uvulopalatopharyngoplasty according to Simmons; UPPP (Fair): Uvulopalatopharyngoplasty according to Fairbanks; BRVTR: Bipolar radiofrequency volumetric tissue reduction; RAUP: Radioassisted uvulopalatopharyngoplasty; RCT: Radiofrequency channeling technique

Characteristics of excluded studies [ordered by study ID]

Ir a:

Study

Reason for exclusion

Abe 1996

No suitable comparison group

Achena 1991

No suitable comparison group

Afzelius 1981

Case series

Anand 1991

No suitable comparison group

Anon 1996

No suitable comparison group

ASDA 1996

Review

Aspinall 2001

Trial comparing anaesthetic agents, and their effect on pain after adeno‐tonsillectomy

Aubert‐Tulkens 1987

Not a trial

Balcerzak 2005

Unclear method of allocation leading to a highly imbalanced distribution of the number of participants between surgery and control

Banerjee 1995

No suitable comparison group

Bear 1980

Case series

Bernecker 1993

No suitable comparison group

Blakley 1986

No suitable comparison group

Borowiecki 1985

Case series

Boudewyns 1995

No suitable comparison group

Bower 1995

No suitable comparison group

Breaux 1995

No suitable comparison group

Brock 1994

Review

Brodsky 1987

Not a trial

Brouilette 1984

No suitable comparison group

Burbach 1993

Not a trial

Burstein 1995

No suitable comparison group

Byrd 1996

No suitable comparison group

Callanan 1994

No suitable comparison group

Calverley 1995

Review

Carenfelt 1993

No suitable comparison group

Cartwright 1988

Not randomised

Castiglione 1992

No suitable comparison group

Chabolle 1988

No suitable comparison group

Chabolle 1995

No suitable comparison group

Chabolle 1995a

No suitable comparison group

Chaska 1995

No suitable comparison group

Chetty 1994

No suitable comparison group

Chua 1994

No suitable comparison group

Cimimo 1995

Not a trial

Cimimo 1995a

No suitable comparison group

Clauser 1996

No suitable comparison group

Clerk 1994

Not surgery

Coleman 1991

Not a trial

Crampette 1992

Review

Croft 1990

No suitable comparison group

Cvetnic 1995

No suitable comparison group

Dickson 1987

Case series

Dierks 1990

Case series

Djupesland 1992

Case series

Doghramji 1995

No suitable comparison group

Donnelly 1994

No suitable comparison group

Douglas 1994a

No suitable comparison group

Douglas 1994b

Review

Douglas 1995

No suitable comparison group

Ejnell 1992

No suitable comparison group

ElSheikh 1996

No suitable comparison group

Engleman 1994

Not surgery

Fietze 1993

No suitable comparison group

Findley 1989

Review

Finkelstein 1995

No suitable comparison group

Finkelstein 1995a

No suitable comparison group

Fraser 1994

Review

Freezer 1995

No suitable comparison group

Freezer 1996

No suitable comparison group

Friberg 1995

No suitable comparison group

Fried 1995

No suitable comparison group

Frith 1985

No suitable comparison group

Fujita 1981

Case series

Fujita 1985

case series

Fujita 1991

Case series

Fujita 1991a

Case series

Furlow 1986

No suitable comparison group

Gislason 1988

Case series

Grunstein 1995

Not surgery

Gryczynska 1995

No suitable comparison group

Guileminault 1986

No suitable comparison group

Guilleminault 1983

Case series

Haraldsson 1990

Review

Haraldsson 1995

No suitable comparison group

Haraldsson 1995a

No suitable comparison group

Harmon 1986

Case series

He 1988

No suitable comparison group

Hester 1995

No suitable comparison group

Hochban 1994

Case series

Hochban 1995

Not a trial

Hochban 1995a

No suitable comparison group

Hochban 1996

No suitable comparison group

Hoffman 1995

No suitable comparison group

Hoffstein 1996

Not a trial

Hoijer 1992

No suitable comparison group

Hudgel 1991

Case series

Hudgel 1996

Review

Hultcrantz 1999

Randomised study assessing the effects of post‐operative pain relief.

Ishizuka 1996

No suitable comparison group

Jakubikova 1996

No suitable comparison group

Janson 1994

No suitable comparison group

Johnson 1994

Case series

Kamami 1994

No suitable comparison group

Kamami 1994a

No suitable comparison group

Kanami 1994

No suitable comparison group

Katsantonis 1988

Review

Kawano 1996

Case series

Keenan 1994

Case series

Keilmann 1995

No suitable comparison group

Khan 1995

Not surgery

Kimmelman 1985

Not a trial

Klonoff 1987

No suitable comparison group

Kobayashi 1996

Case report

Kosho 1995

No suitable comparison group

Kotecha 2007

Study primarily aimed at reducing snoring in people +/‐ OSA

Krespi 1994

Case series

Krieger 1988

Review

L'Estrange 1995

No suitable comparison group

Lacahanas 2005

Study assessed immediate post‐operative effects in a mixed population (including people with OSA). Not specifically designed to address efficacy.

Larsson 1994

Case series

Leiter 1996

No suitable comparison group

Liistro 1995

No suitable comparison group

Loui 1994

Case series

Lu 1995

No suitable comparison group

Lysdahl 2002

Non‐randomised prospective study.

MacCallum 2000

Study of trachestomies, non‐randomised, with only 1 sleep apnoea patient

Maisel 1992

No suitable comparison group

Marcus 1990

No suitable comparison group

Marcus 1996

No suitable comparison group

Marrone 1995

No suitable comparison group

Matsuda 1995

Case report

Mayer 1995

Case report

McGuirt 1995

Case series

Mickelson 1996

No suitable comparison group

Miljeteig 1992

Case series

Min 1995

Case series

Minarikova 1995

Case series

Mintz 1995

Not a trial

Miyazaki 1989

Case series

Mochizuki 1996

Case series

Mochizuki 1996a

Case series

Mondain 1994

Not a trial

Morin 1994

Review

Murakami 2002

Retrospective analysis.

Nakai 1995

Case series

Nimkarn 1995

No suitable comparison group

Nishimura 1996

Case series

Noseda 1996

Not surgery

Ohta 1993

Not a trial

Paaske 1994

Case report

Pack 1994

Review

Partinen 1988

Case series

Partinen 1990

Case series

Partinen 1996

Review

Penek 1995

Review

Peng 1995

Case series

Peter 1995

Review

Piper 1995

Case series

Polo 1994

Review

Pories 1995

Not OSA

Potsic 1987

Case series

Prinz 1995

Review

Pulido 1995

Case series

Quinn 1995

Case series

Rapoport 1986

Case series

Reimao 1985

Case series

Reimao 1986

Case series

Riley 1989

Case series

Riley 1990

Case series

Riley 1990a

Not randomised

Riley 1994

Case series

Riley 1995

Review

Rodenstein 1992

Review

Rodenstein 1995

Not a trial

Rodrigues 2002

Not randomised

Rothschild 1995

Case series

Sangal 1992

Not surgery

Schechtman 1995

Review

SchultzCoulon 1996

Case series

Schwartz 1992

Case series

Sdralis 1996

Case series

Semple 1993

Review

Series 1992

Case series

Sher 1985

No suitable comparison group

Sher 1995

Review

Sher 1996

Not a trial

Sher et al 1996

Not a trial

Simmons 1984

Case series

Simonds 1994

Not a trial

Skatvedt 1995

Case series

Stradling 1990

Review

Stradling 1990a

Not a trial

Stradling 1995

Review

Strollo 1996

Not a trial

Suen 1995

No suitable comparison group

Sugerman 1986

Case series

Sullivan 1985

Review

Tangugsorn 1995

Not surgery

Tangugsorn 1995a

Not surgery

Terris 1996

Case series

Terris 2002

RCT assessing the effects of two surgical techniques. This study was excluded due to low baseline AHI scores in many of the participants. The SDs indicated that a significant proportion of the participants would not be considered OSA sufferers (combined mean: 6.1, SD 5.18).

Thalhofer 1995

Case series

Thorpy 1994

Review

Troell 2000

Patient preference comparison of effect of several types of surgery on post‐operative pain in snoring or sleep‐disordered breathing, including sleep apnoea

Truy 1995

Not sleep apnoea

Verse 2002

Before and after study

Wakeing 1996

Case series

Waldhorn 1990

Not surgery

Walker 1989

Case series

Walker 1995

Case series

Weiss 1995

Case series

Wetmore 1986

Case series

Wiltfang 1996

Case series

Woodson 1994

Case series

Woodson 1996

No suitable comparison group

Wright 1995

Review

Yamadera 1994

Case series

Yamadera 1995

No suitable comparison group

Yoder 1995

Review

Zohar 1993

Not randomised

Zorick 1983

Case series

Zorick 1989

Not randomised

Zorick 1990

Case series

Data and analyses

Open in table viewer
Comparison 1. TCRFTA versus sham TCRFTA

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change from baseline in AHI Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 1.1
Comparison 1 TCRFTA versus sham TCRFTA, Outcome 1 Change from baseline in AHI.

Comparison 1 TCRFTA versus sham TCRFTA, Outcome 1 Change from baseline in AHI.

2 Change from baseline in Epworth sleepiness score Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 1.2
Comparison 1 TCRFTA versus sham TCRFTA, Outcome 2 Change from baseline in Epworth sleepiness score.

Comparison 1 TCRFTA versus sham TCRFTA, Outcome 2 Change from baseline in Epworth sleepiness score.

3 Change from baseline in quality of life (Functional Outcome of Sleep Questionnaire) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 1.3
Comparison 1 TCRFTA versus sham TCRFTA, Outcome 3 Change from baseline in quality of life (Functional Outcome of Sleep Questionnaire).

Comparison 1 TCRFTA versus sham TCRFTA, Outcome 3 Change from baseline in quality of life (Functional Outcome of Sleep Questionnaire).

4 Pain @ 1 week (VAS score) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 1.4
Comparison 1 TCRFTA versus sham TCRFTA, Outcome 4 Pain @ 1 week (VAS score).

Comparison 1 TCRFTA versus sham TCRFTA, Outcome 4 Pain @ 1 week (VAS score).

5 Pain @ 3 weeks (VAS score) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 1.5
Comparison 1 TCRFTA versus sham TCRFTA, Outcome 5 Pain @ 3 weeks (VAS score).

Comparison 1 TCRFTA versus sham TCRFTA, Outcome 5 Pain @ 3 weeks (VAS score).
Open in table viewer
Comparison 2. Laser assisted UP versus conservative management

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 AHI Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 2.1
Comparison 2 Laser assisted UP versus conservative management, Outcome 1 AHI.

Comparison 2 Laser assisted UP versus conservative management, Outcome 1 AHI.

2 Epworth sleepiness score Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 2.2
Comparison 2 Laser assisted UP versus conservative management, Outcome 2 Epworth sleepiness score.

Comparison 2 Laser assisted UP versus conservative management, Outcome 2 Epworth sleepiness score.

3 Quality of life (sleep apnoea quality of life index) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 2.3
Comparison 2 Laser assisted UP versus conservative management, Outcome 3 Quality of life (sleep apnoea quality of life index).

Comparison 2 Laser assisted UP versus conservative management, Outcome 3 Quality of life (sleep apnoea quality of life index).

4 Snoring intensity (VAS) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 2.4
Comparison 2 Laser assisted UP versus conservative management, Outcome 4 Snoring intensity (VAS).

Comparison 2 Laser assisted UP versus conservative management, Outcome 4 Snoring intensity (VAS).

5 Snoring frequency score (VAS) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 2.5
Comparison 2 Laser assisted UP versus conservative management, Outcome 5 Snoring frequency score (VAS).

Comparison 2 Laser assisted UP versus conservative management, Outcome 5 Snoring frequency score (VAS).

6 Withdrawals Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 2.6
Comparison 2 Laser assisted UP versus conservative management, Outcome 6 Withdrawals.

Comparison 2 Laser assisted UP versus conservative management, Outcome 6 Withdrawals.

7 Dysphagia Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 2.7
Comparison 2 Laser assisted UP versus conservative management, Outcome 7 Dysphagia.

Comparison 2 Laser assisted UP versus conservative management, Outcome 7 Dysphagia.

8 Infection Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 2.8
Comparison 2 Laser assisted UP versus conservative management, Outcome 8 Infection.

Comparison 2 Laser assisted UP versus conservative management, Outcome 8 Infection.

9 Bleeding (mild‐severe) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 2.9
Comparison 2 Laser assisted UP versus conservative management, Outcome 9 Bleeding (mild‐severe).

Comparison 2 Laser assisted UP versus conservative management, Outcome 9 Bleeding (mild‐severe).

10 Pain Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 2.10
Comparison 2 Laser assisted UP versus conservative management, Outcome 10 Pain.

Comparison 2 Laser assisted UP versus conservative management, Outcome 10 Pain.

11 Nasal regurgitation Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 2.11
Comparison 2 Laser assisted UP versus conservative management, Outcome 11 Nasal regurgitation.

Comparison 2 Laser assisted UP versus conservative management, Outcome 11 Nasal regurgitation.
Open in table viewer
Comparison 3. UPPP versus conservative management

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Excessive daytime sleepiness (VAS) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 3.1
Comparison 3 UPPP versus conservative management, Outcome 1 Excessive daytime sleepiness (VAS).

Comparison 3 UPPP versus conservative management, Outcome 1 Excessive daytime sleepiness (VAS).

2 Falling asleep when not in bed Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 3.2
Comparison 3 UPPP versus conservative management, Outcome 2 Falling asleep when not in bed.

Comparison 3 UPPP versus conservative management, Outcome 2 Falling asleep when not in bed.

3 ODI4 Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 3.3
Comparison 3 UPPP versus conservative management, Outcome 3 ODI4.

Comparison 3 UPPP versus conservative management, Outcome 3 ODI4.

4 ODI10 Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 3.4
Comparison 3 UPPP versus conservative management, Outcome 4 ODI10.

Comparison 3 UPPP versus conservative management, Outcome 4 ODI10.

5 Withdrawals Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 3.5
Comparison 3 UPPP versus conservative management, Outcome 5 Withdrawals.

Comparison 3 UPPP versus conservative management, Outcome 5 Withdrawals.

6 Dysphagia Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 3.6
Comparison 3 UPPP versus conservative management, Outcome 6 Dysphagia.

Comparison 3 UPPP versus conservative management, Outcome 6 Dysphagia.
Open in table viewer
Comparison 4. Palatal implants versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in AHI Show forest plot

1

Mean Difference (Fixed, 95% CI)

Totals not selected
Analysis 4.1
Comparison 4 Palatal implants versus placebo, Outcome 1 Mean change in AHI.

Comparison 4 Palatal implants versus placebo, Outcome 1 Mean change in AHI.

2 Mean change in Epworth sleepiness scores Show forest plot

1

Mean Difference (Fixed, 95% CI)

Totals not selected
Analysis 4.2
Comparison 4 Palatal implants versus placebo, Outcome 2 Mean change in Epworth sleepiness scores.

Comparison 4 Palatal implants versus placebo, Outcome 2 Mean change in Epworth sleepiness scores.

3 Change from baseline in quality of life (SF‐36) Show forest plot

1

Mean Difference (Fixed, 95% CI)

Totals not selected
Analysis 4.3
Comparison 4 Palatal implants versus placebo, Outcome 3 Change from baseline in quality of life (SF‐36).

Comparison 4 Palatal implants versus placebo, Outcome 3 Change from baseline in quality of life (SF‐36).

4 Loss to follow‐up Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 4.4
Comparison 4 Palatal implants versus placebo, Outcome 4 Loss to follow‐up.

Comparison 4 Palatal implants versus placebo, Outcome 4 Loss to follow‐up.
Open in table viewer
Comparison 5. UPPP versus oral appliance therapy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Apnoea Hypopnea Index Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 5.1
Comparison 5 UPPP versus oral appliance therapy, Outcome 1 Apnoea Hypopnea Index.

Comparison 5 UPPP versus oral appliance therapy, Outcome 1 Apnoea Hypopnea Index.

1.1 6 months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 1 year

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 4 years

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Quality of life: Vitality Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 5.2
Comparison 5 UPPP versus oral appliance therapy, Outcome 2 Quality of life: Vitality.

Comparison 5 UPPP versus oral appliance therapy, Outcome 2 Quality of life: Vitality.

3 Quality of life: Contentment Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 5.3
Comparison 5 UPPP versus oral appliance therapy, Outcome 3 Quality of life: Contentment.

Comparison 5 UPPP versus oral appliance therapy, Outcome 3 Quality of life: Contentment.

4 Quality of life: Sleep Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 5.4
Comparison 5 UPPP versus oral appliance therapy, Outcome 4 Quality of life: Sleep.

Comparison 5 UPPP versus oral appliance therapy, Outcome 4 Quality of life: Sleep.

5 Oxygen desaturation index Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 5.5
Comparison 5 UPPP versus oral appliance therapy, Outcome 5 Oxygen desaturation index.

Comparison 5 UPPP versus oral appliance therapy, Outcome 5 Oxygen desaturation index.

5.1 6 months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 1 year

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 4 years

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Withdrawals Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 5.6
Comparison 5 UPPP versus oral appliance therapy, Outcome 6 Withdrawals.

Comparison 5 UPPP versus oral appliance therapy, Outcome 6 Withdrawals.

7 Dysphagia Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 5.7
Comparison 5 UPPP versus oral appliance therapy, Outcome 7 Dysphagia.

Comparison 5 UPPP versus oral appliance therapy, Outcome 7 Dysphagia.

8 Nasopharyngeal regurgitation Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 5.8
Comparison 5 UPPP versus oral appliance therapy, Outcome 8 Nasopharyngeal regurgitation.

Comparison 5 UPPP versus oral appliance therapy, Outcome 8 Nasopharyngeal regurgitation.

9 Repeated adjustment Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 5.9
Comparison 5 UPPP versus oral appliance therapy, Outcome 9 Repeated adjustment.

Comparison 5 UPPP versus oral appliance therapy, Outcome 9 Repeated adjustment.
Open in table viewer
Comparison 6. TCRFTA versus CPAP

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change from baseline in Apnoea Hypopnea Index Show forest plot

1

Events/hr (Fixed, 95% CI)

Totals not selected
Analysis 6.1
Comparison 6 TCRFTA versus CPAP, Outcome 1 Mean change from baseline in Apnoea Hypopnea Index.

Comparison 6 TCRFTA versus CPAP, Outcome 1 Mean change from baseline in Apnoea Hypopnea Index.

2 Mean change from baseline in Epworth Sleepiness Score Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 6.2
Comparison 6 TCRFTA versus CPAP, Outcome 2 Mean change from baseline in Epworth Sleepiness Score.

Comparison 6 TCRFTA versus CPAP, Outcome 2 Mean change from baseline in Epworth Sleepiness Score.

3 Quality of life (Functional Outcomes of Sleep Questionnaire) Show forest plot

1

QoL (Fixed, 95% CI)

Totals not selected
Analysis 6.3
Comparison 6 TCRFTA versus CPAP, Outcome 3 Quality of life (Functional Outcomes of Sleep Questionnaire).

Comparison 6 TCRFTA versus CPAP, Outcome 3 Quality of life (Functional Outcomes of Sleep Questionnaire).

4 Withdrawals/loss to follow‐up Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 6.4
Comparison 6 TCRFTA versus CPAP, Outcome 4 Withdrawals/loss to follow‐up.

Comparison 6 TCRFTA versus CPAP, Outcome 4 Withdrawals/loss to follow‐up.
Open in table viewer
Comparison 7. UPPP versus lateral PP

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 AHI Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 7.1
Comparison 7 UPPP versus lateral PP, Outcome 1 AHI.

Comparison 7 UPPP versus lateral PP, Outcome 1 AHI.

2 Change in AHI from baseline Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 7.2
Comparison 7 UPPP versus lateral PP, Outcome 2 Change in AHI from baseline.

Comparison 7 UPPP versus lateral PP, Outcome 2 Change in AHI from baseline.

3 Nasal regurgitation Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 7.3
Comparison 7 UPPP versus lateral PP, Outcome 3 Nasal regurgitation.

Comparison 7 UPPP versus lateral PP, Outcome 3 Nasal regurgitation.

4 Withdrawals Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 7.4
Comparison 7 UPPP versus lateral PP, Outcome 4 Withdrawals.

Comparison 7 UPPP versus lateral PP, Outcome 4 Withdrawals.
Open in table viewer
Comparison 8. Tongue advancement + palatopharyngoplasty versus tongue suspension + palatopharyngoplasty

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Epworth sleepiness scores Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 8.1
Comparison 8 Tongue advancement + palatopharyngoplasty versus tongue suspension + palatopharyngoplasty, Outcome 1 Epworth sleepiness scores.

Comparison 8 Tongue advancement + palatopharyngoplasty versus tongue suspension + palatopharyngoplasty, Outcome 1 Epworth sleepiness scores.

Open in table viewer
Comparison 9. RAUP versus submucosal channeling technique

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Reduction in AHI below 10 Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 9.1
Comparison 9 RAUP versus submucosal channeling technique, Outcome 1 Reduction in AHI below 10.

Comparison 9 RAUP versus submucosal channeling technique, Outcome 1 Reduction in AHI below 10.

2 Pain score Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 9.2
Comparison 9 RAUP versus submucosal channeling technique, Outcome 2 Pain score.

Comparison 9 RAUP versus submucosal channeling technique, Outcome 2 Pain score.

3 Dysphagia Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 9.3
Comparison 9 RAUP versus submucosal channeling technique, Outcome 3 Dysphagia.

Comparison 9 RAUP versus submucosal channeling technique, Outcome 3 Dysphagia.
Open in table viewer
Comparison 10. Expansion sphincter pharyngoplasty (ESP) versus UPPP

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 AHI Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Analysis 10.1
Comparison 10 Expansion sphincter pharyngoplasty (ESP) versus UPPP, Outcome 1 AHI.

Comparison 10 Expansion sphincter pharyngoplasty (ESP) versus UPPP, Outcome 1 AHI.

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figuras y tablas -
Figure 1

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

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Comparison 1 TCRFTA versus sham TCRFTA, Outcome 1 Change from baseline in AHI.
Figuras y tablas -
Analysis 1.1

Comparison 1 TCRFTA versus sham TCRFTA, Outcome 1 Change from baseline in AHI.

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Comparison 1 TCRFTA versus sham TCRFTA, Outcome 2 Change from baseline in Epworth sleepiness score.
Figuras y tablas -
Analysis 1.2

Comparison 1 TCRFTA versus sham TCRFTA, Outcome 2 Change from baseline in Epworth sleepiness score.

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Comparison 1 TCRFTA versus sham TCRFTA, Outcome 3 Change from baseline in quality of life (Functional Outcome of Sleep Questionnaire).
Figuras y tablas -
Analysis 1.3

Comparison 1 TCRFTA versus sham TCRFTA, Outcome 3 Change from baseline in quality of life (Functional Outcome of Sleep Questionnaire).

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Comparison 1 TCRFTA versus sham TCRFTA, Outcome 4 Pain @ 1 week (VAS score).
Figuras y tablas -
Analysis 1.4

Comparison 1 TCRFTA versus sham TCRFTA, Outcome 4 Pain @ 1 week (VAS score).

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Comparison 1 TCRFTA versus sham TCRFTA, Outcome 5 Pain @ 3 weeks (VAS score).
Figuras y tablas -
Analysis 1.5

Comparison 1 TCRFTA versus sham TCRFTA, Outcome 5 Pain @ 3 weeks (VAS score).

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Comparison 2 Laser assisted UP versus conservative management, Outcome 1 AHI.
Figuras y tablas -
Analysis 2.1

Comparison 2 Laser assisted UP versus conservative management, Outcome 1 AHI.

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Comparison 2 Laser assisted UP versus conservative management, Outcome 2 Epworth sleepiness score.
Figuras y tablas -
Analysis 2.2

Comparison 2 Laser assisted UP versus conservative management, Outcome 2 Epworth sleepiness score.

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Comparison 2 Laser assisted UP versus conservative management, Outcome 3 Quality of life (sleep apnoea quality of life index).
Figuras y tablas -
Analysis 2.3

Comparison 2 Laser assisted UP versus conservative management, Outcome 3 Quality of life (sleep apnoea quality of life index).

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Comparison 2 Laser assisted UP versus conservative management, Outcome 4 Snoring intensity (VAS).
Figuras y tablas -
Analysis 2.4

Comparison 2 Laser assisted UP versus conservative management, Outcome 4 Snoring intensity (VAS).

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Comparison 2 Laser assisted UP versus conservative management, Outcome 5 Snoring frequency score (VAS).
Figuras y tablas -
Analysis 2.5

Comparison 2 Laser assisted UP versus conservative management, Outcome 5 Snoring frequency score (VAS).

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Comparison 2 Laser assisted UP versus conservative management, Outcome 6 Withdrawals.
Figuras y tablas -
Analysis 2.6

Comparison 2 Laser assisted UP versus conservative management, Outcome 6 Withdrawals.

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Comparison 2 Laser assisted UP versus conservative management, Outcome 7 Dysphagia.
Figuras y tablas -
Analysis 2.7

Comparison 2 Laser assisted UP versus conservative management, Outcome 7 Dysphagia.

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Comparison 2 Laser assisted UP versus conservative management, Outcome 8 Infection.
Figuras y tablas -
Analysis 2.8

Comparison 2 Laser assisted UP versus conservative management, Outcome 8 Infection.

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Comparison 2 Laser assisted UP versus conservative management, Outcome 9 Bleeding (mild‐severe).
Figuras y tablas -
Analysis 2.9

Comparison 2 Laser assisted UP versus conservative management, Outcome 9 Bleeding (mild‐severe).

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Comparison 2 Laser assisted UP versus conservative management, Outcome 10 Pain.
Figuras y tablas -
Analysis 2.10

Comparison 2 Laser assisted UP versus conservative management, Outcome 10 Pain.

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Comparison 2 Laser assisted UP versus conservative management, Outcome 11 Nasal regurgitation.
Figuras y tablas -
Analysis 2.11

Comparison 2 Laser assisted UP versus conservative management, Outcome 11 Nasal regurgitation.

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Comparison 3 UPPP versus conservative management, Outcome 1 Excessive daytime sleepiness (VAS).
Figuras y tablas -
Analysis 3.1

Comparison 3 UPPP versus conservative management, Outcome 1 Excessive daytime sleepiness (VAS).

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Comparison 3 UPPP versus conservative management, Outcome 2 Falling asleep when not in bed.
Figuras y tablas -
Analysis 3.2

Comparison 3 UPPP versus conservative management, Outcome 2 Falling asleep when not in bed.

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Comparison 3 UPPP versus conservative management, Outcome 3 ODI4.
Figuras y tablas -
Analysis 3.3

Comparison 3 UPPP versus conservative management, Outcome 3 ODI4.

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Comparison 3 UPPP versus conservative management, Outcome 4 ODI10.
Figuras y tablas -
Analysis 3.4

Comparison 3 UPPP versus conservative management, Outcome 4 ODI10.

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Comparison 3 UPPP versus conservative management, Outcome 5 Withdrawals.
Figuras y tablas -
Analysis 3.5

Comparison 3 UPPP versus conservative management, Outcome 5 Withdrawals.

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Comparison 3 UPPP versus conservative management, Outcome 6 Dysphagia.
Figuras y tablas -
Analysis 3.6

Comparison 3 UPPP versus conservative management, Outcome 6 Dysphagia.

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Comparison 4 Palatal implants versus placebo, Outcome 1 Mean change in AHI.
Figuras y tablas -
Analysis 4.1

Comparison 4 Palatal implants versus placebo, Outcome 1 Mean change in AHI.

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Comparison 4 Palatal implants versus placebo, Outcome 2 Mean change in Epworth sleepiness scores.
Figuras y tablas -
Analysis 4.2

Comparison 4 Palatal implants versus placebo, Outcome 2 Mean change in Epworth sleepiness scores.

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Comparison 4 Palatal implants versus placebo, Outcome 3 Change from baseline in quality of life (SF‐36).
Figuras y tablas -
Analysis 4.3

Comparison 4 Palatal implants versus placebo, Outcome 3 Change from baseline in quality of life (SF‐36).

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Comparison 4 Palatal implants versus placebo, Outcome 4 Loss to follow‐up.
Figuras y tablas -
Analysis 4.4

Comparison 4 Palatal implants versus placebo, Outcome 4 Loss to follow‐up.

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Comparison 5 UPPP versus oral appliance therapy, Outcome 1 Apnoea Hypopnea Index.
Figuras y tablas -
Analysis 5.1

Comparison 5 UPPP versus oral appliance therapy, Outcome 1 Apnoea Hypopnea Index.

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Comparison 5 UPPP versus oral appliance therapy, Outcome 2 Quality of life: Vitality.
Figuras y tablas -
Analysis 5.2

Comparison 5 UPPP versus oral appliance therapy, Outcome 2 Quality of life: Vitality.

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Comparison 5 UPPP versus oral appliance therapy, Outcome 3 Quality of life: Contentment.
Figuras y tablas -
Analysis 5.3

Comparison 5 UPPP versus oral appliance therapy, Outcome 3 Quality of life: Contentment.

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Comparison 5 UPPP versus oral appliance therapy, Outcome 4 Quality of life: Sleep.
Figuras y tablas -
Analysis 5.4

Comparison 5 UPPP versus oral appliance therapy, Outcome 4 Quality of life: Sleep.

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Comparison 5 UPPP versus oral appliance therapy, Outcome 5 Oxygen desaturation index.
Figuras y tablas -
Analysis 5.5

Comparison 5 UPPP versus oral appliance therapy, Outcome 5 Oxygen desaturation index.

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Comparison 5 UPPP versus oral appliance therapy, Outcome 6 Withdrawals.
Figuras y tablas -
Analysis 5.6

Comparison 5 UPPP versus oral appliance therapy, Outcome 6 Withdrawals.

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Comparison 5 UPPP versus oral appliance therapy, Outcome 7 Dysphagia.
Figuras y tablas -
Analysis 5.7

Comparison 5 UPPP versus oral appliance therapy, Outcome 7 Dysphagia.

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Comparison 5 UPPP versus oral appliance therapy, Outcome 8 Nasopharyngeal regurgitation.
Figuras y tablas -
Analysis 5.8

Comparison 5 UPPP versus oral appliance therapy, Outcome 8 Nasopharyngeal regurgitation.

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Comparison 5 UPPP versus oral appliance therapy, Outcome 9 Repeated adjustment.
Figuras y tablas -
Analysis 5.9

Comparison 5 UPPP versus oral appliance therapy, Outcome 9 Repeated adjustment.

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Comparison 6 TCRFTA versus CPAP, Outcome 1 Mean change from baseline in Apnoea Hypopnea Index.
Figuras y tablas -
Analysis 6.1

Comparison 6 TCRFTA versus CPAP, Outcome 1 Mean change from baseline in Apnoea Hypopnea Index.

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Comparison 6 TCRFTA versus CPAP, Outcome 2 Mean change from baseline in Epworth Sleepiness Score.
Figuras y tablas -
Analysis 6.2

Comparison 6 TCRFTA versus CPAP, Outcome 2 Mean change from baseline in Epworth Sleepiness Score.

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Comparison 6 TCRFTA versus CPAP, Outcome 3 Quality of life (Functional Outcomes of Sleep Questionnaire).
Figuras y tablas -
Analysis 6.3

Comparison 6 TCRFTA versus CPAP, Outcome 3 Quality of life (Functional Outcomes of Sleep Questionnaire).

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Comparison 6 TCRFTA versus CPAP, Outcome 4 Withdrawals/loss to follow‐up.
Figuras y tablas -
Analysis 6.4

Comparison 6 TCRFTA versus CPAP, Outcome 4 Withdrawals/loss to follow‐up.

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Comparison 7 UPPP versus lateral PP, Outcome 1 AHI.
Figuras y tablas -
Analysis 7.1

Comparison 7 UPPP versus lateral PP, Outcome 1 AHI.

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Comparison 7 UPPP versus lateral PP, Outcome 2 Change in AHI from baseline.
Figuras y tablas -
Analysis 7.2

Comparison 7 UPPP versus lateral PP, Outcome 2 Change in AHI from baseline.

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Comparison 7 UPPP versus lateral PP, Outcome 3 Nasal regurgitation.
Figuras y tablas -
Analysis 7.3

Comparison 7 UPPP versus lateral PP, Outcome 3 Nasal regurgitation.

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Comparison 7 UPPP versus lateral PP, Outcome 4 Withdrawals.
Figuras y tablas -
Analysis 7.4

Comparison 7 UPPP versus lateral PP, Outcome 4 Withdrawals.

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Comparison 8 Tongue advancement + palatopharyngoplasty versus tongue suspension + palatopharyngoplasty, Outcome 1 Epworth sleepiness scores.
Figuras y tablas -
Analysis 8.1

Comparison 8 Tongue advancement + palatopharyngoplasty versus tongue suspension + palatopharyngoplasty, Outcome 1 Epworth sleepiness scores.

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Comparison 9 RAUP versus submucosal channeling technique, Outcome 1 Reduction in AHI below 10.
Figuras y tablas -
Analysis 9.1

Comparison 9 RAUP versus submucosal channeling technique, Outcome 1 Reduction in AHI below 10.

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Comparison 9 RAUP versus submucosal channeling technique, Outcome 2 Pain score.
Figuras y tablas -
Analysis 9.2

Comparison 9 RAUP versus submucosal channeling technique, Outcome 2 Pain score.

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Comparison 9 RAUP versus submucosal channeling technique, Outcome 3 Dysphagia.
Figuras y tablas -
Analysis 9.3

Comparison 9 RAUP versus submucosal channeling technique, Outcome 3 Dysphagia.

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Comparison 10 Expansion sphincter pharyngoplasty (ESP) versus UPPP, Outcome 1 AHI.
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Analysis 10.1

Comparison 10 Expansion sphincter pharyngoplasty (ESP) versus UPPP, Outcome 1 AHI.

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Table 1. Search history

Search dates

References

Initial version of the review

A total of 594 articles were identified through electronic searching, 44 through correspondence and a further 28 through hand‐searching reference lists. Of these, 656 articles were excluded because of the following non‐inclusive reasons: did not focus on sleep apnoea (n=134); did not look at surgical interventions (n=328); obviously not an RCT (overviews, letters, case series etc.) (n=194). Ten articles, for which full text reports were obtained, were assessed for inclusion by both reviewers. All of these articles were excluded, five because they were descriptions of a surgical procedure, reviews or letters, four because they were not intervention studies and one was not about sleep apnoea. There was no disagreement on final inclusion/exclusion of studies.

Update ‐ July 2004

An update search was conducted in July 2004. 110 references identified; 15 retrieved for further scrutiny.

Seven studies met the inclusion criteria (Lojander 1996; Tegelberg 1999; Ferguson 2003; Cahali 2003; Naya 2002; Woodson 2003, Thomas 2003).

One non‐English language article is awaiting assessment.

Seven studies failed to meet the inclusion criteria of the review

Update ‐ July 2005

An update search was conducted in July 2005. 20 references were identified and two studies were retrieved for additional scrutiny. Of these, one trial met the inclusion criteria (Larrosa 2004) and another pertains to an ongoing study (Tommi 2004). Both studies have a sham surgical procedure as a control arm.

Update ‐ July 2006

A total of 10 references were identified from electronic literature searches. Three of these were obtained as full‐text papers. Two studies failed to meet the entry criteria of the review, and a further study is awaiting assessment. One new trial of 150 participants met the entry criteria of the review (Atef 2005).

Update ‐ July 2007

A total of 11 references were identified from electronic literature searches. One was retrieved as full‐text and met the entry criteria of the review. This study added data from 40 participants (Bassiouny 2007).

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Table 1. Search history
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Comparison 1. TCRFTA versus sham TCRFTA

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change from baseline in AHI Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Change from baseline in Epworth sleepiness score Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Change from baseline in quality of life (Functional Outcome of Sleep Questionnaire) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4 Pain @ 1 week (VAS score) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5 Pain @ 3 weeks (VAS score) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
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Comparison 1. TCRFTA versus sham TCRFTA
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Comparison 2. Laser assisted UP versus conservative management

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 AHI Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Epworth sleepiness score Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Quality of life (sleep apnoea quality of life index) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4 Snoring intensity (VAS) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5 Snoring frequency score (VAS) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

6 Withdrawals Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

7 Dysphagia Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

8 Infection Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

9 Bleeding (mild‐severe) Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

10 Pain Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

11 Nasal regurgitation Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
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Comparison 2. Laser assisted UP versus conservative management
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Comparison 3. UPPP versus conservative management

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Excessive daytime sleepiness (VAS) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Falling asleep when not in bed Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 ODI4 Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4 ODI10 Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5 Withdrawals Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

6 Dysphagia Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
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Comparison 3. UPPP versus conservative management
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Comparison 4. Palatal implants versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in AHI Show forest plot

1

Mean Difference (Fixed, 95% CI)

Totals not selected

2 Mean change in Epworth sleepiness scores Show forest plot

1

Mean Difference (Fixed, 95% CI)

Totals not selected

3 Change from baseline in quality of life (SF‐36) Show forest plot

1

Mean Difference (Fixed, 95% CI)

Totals not selected

4 Loss to follow‐up Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
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Comparison 4. Palatal implants versus placebo
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Comparison 5. UPPP versus oral appliance therapy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Apnoea Hypopnea Index Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

1.1 6 months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 1 year

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 4 years

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Quality of life: Vitality Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Quality of life: Contentment Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4 Quality of life: Sleep Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5 Oxygen desaturation index Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5.1 6 months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 1 year

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 4 years

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Withdrawals Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

7 Dysphagia Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

8 Nasopharyngeal regurgitation Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

9 Repeated adjustment Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
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Comparison 5. UPPP versus oral appliance therapy
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Comparison 6. TCRFTA versus CPAP

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change from baseline in Apnoea Hypopnea Index Show forest plot

1

Events/hr (Fixed, 95% CI)

Totals not selected

2 Mean change from baseline in Epworth Sleepiness Score Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Quality of life (Functional Outcomes of Sleep Questionnaire) Show forest plot

1

QoL (Fixed, 95% CI)

Totals not selected

4 Withdrawals/loss to follow‐up Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
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Comparison 6. TCRFTA versus CPAP
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Comparison 7. UPPP versus lateral PP

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 AHI Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Change in AHI from baseline Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Nasal regurgitation Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4 Withdrawals Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
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Comparison 7. UPPP versus lateral PP
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Comparison 8. Tongue advancement + palatopharyngoplasty versus tongue suspension + palatopharyngoplasty

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Epworth sleepiness scores Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 8. Tongue advancement + palatopharyngoplasty versus tongue suspension + palatopharyngoplasty
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Comparison 9. RAUP versus submucosal channeling technique

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Reduction in AHI below 10 Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Pain score Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Dysphagia Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
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Comparison 9. RAUP versus submucosal channeling technique
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Comparison 10. Expansion sphincter pharyngoplasty (ESP) versus UPPP

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 AHI Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 10. Expansion sphincter pharyngoplasty (ESP) versus UPPP
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