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Review
. 2018 Sep 25;5(1):49-56.
doi: 10.1016/j.wjorl.2018.05.007. eCollection 2019 Mar.

Cautery-assisted Palatal Stiffening Operation for Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

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Free PMC article
Review

Cautery-assisted Palatal Stiffening Operation for Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

Charles M Llewellyn et al. World J Otorhinolaryngol Head Neck Surg. .
Free PMC article

Abstract

Objective: To systematically review outcomes for cautery-assisted palatal stiffening operation (CAPSO) as a treatment for adult obstructive sleep apnea (OSA).

Methods: Five databases (including PubMed/MEDLINE) were searched through July 12, 2017.

Results: Eight studies (307 patients) met criteria. Overall, CAPSO alone (80 patients) improved AHI from a mean ± standard deviation (M ± SD) of (16.8 ± 11.9) to (9.9 ± 10.9) events/h (41.1% decrease). Mixed CAPSO with/without tonsillectomy (92 patients) improved AHI from a M ± SD of (24.8 ± 12.6) to (10.6 ± 9.5) events/h (61.7% decrease). CAPSO with expansion pharyngoplasty (EP), (78 patients) improved AHI from a M ± SD of (26.3 ± 17.7) to (12.6 ± 5.8) events/h (52.1% decrease). CAPSO alone (90 patients) improved lowest oxygen saturation (LSAT) by 5.4 points. Mixed CAPSO with/without tonsillectomy (77 patients) improved LSAT by 10.6 points, and CAPSO with EP (78 patients) improved LSAT by 5.2 points. Sleepiness improved (182 patients) from an Epworth Sleepiness Scale score of 11.8 to 5.1, P < 0.001. Snoring reduced (120 patients) from 7.9 to 2.5 on visual analog scales (0-10 scale), P < 0.001.

Conclusions: Apnea-hypopnea index has improved by 41.0% for CAPSO alone, 61.7% for CAPSO with tonsillectomy and 52.1% for CAPSO with expansion pharyngoplasty. Additionally, lowest oxygen saturation, sleepiness and snoring have also improved after CAPSO.

Keywords: Meta-analysis; Sleep apnea syndromes; Surgery; Systematic review.

Figures

Figure 1
Figure 1
Flow diagram demonstrating literature search, study inclusion and exclusion.
Figure 2
Figure 2
Mean Difference in AHI Pre- and Post-CAPSO, with 95%CI (Top); Standardized Mean Difference in AHI pre- and post-CAPSO, with 95%CI (Bottom). AHI: apnea-hypopnea index; CAPSO: cautery-assisted palatal stiffening operation.
Figure 3
Figure 3
Mean Difference in LSAT Pre- and Post-CAPSO, with 95%CI (Top); Standardized Mean Difference in LSAT pre- and post-CAPSO, with 95%CI (Bottom). Abbreviations: LSAT = lowest oxygen saturation; CAPSO = cautery-assisted palatal stiffening operation.

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