A new technique for laser-assisted uvulopalatoplasty: Decision-tree analysis and results

Objective: Report a new technique of laser-assisted uvulopalatoplasty (LAUP) for snoring performed as a one-stage procedure. Study Design: A decision-tree was used in a prospective study of 89 patients from April 1994 to May 1997, It included a fiberscopy and Muller's maneuver, rhinomanometry, pH monitoring, computed tomography scan to measure the pharyngeal lumen, pulse oximetry and polysomnography in case of sleep apnea syndrome was suspected. Methods: The authors performed their LAUP technique on 43 patients (48.5%) whose snoring was mainly caused by the velum, This technique consists of scarifying the velum by vaporizing the mucosa and the submucosa along a rectangle extending from the palatal dimple to the uvula and having a width of 1.5 to 2 cm, Vaporization of the palatal arches follows without exceeding the junction of the anterior and posterior pillars in height. The uvula is cut if necessary, preserving a length of at least 0.5 cm. The other patients under-went different procedures according to the cause of snoring Results: There was no significant difference between LAUP and uvulopalatoplasty (UPPP) regarding pain. No permanent phonatory disorders and no regurgitation occurred. Satisfaction evaluated on a scale ranging from 0 to 10 was equivalent for the two techniques: mean value = 7.68 (+/-2.18) for LAUP and 8.60 (+/-2.27) for UPPP. The mean followup was 17 months (range, 1-37 mo), Satisfaction was also identical for all techniques. Conclusion: Our LAUP technique combined with other procedures according to a decision-tree is efficient and safe.