Conventional, Laser-Assisted and Coblation-Assisted Uvulopalatopharyngoplasty/Uvulopalatoplasty: Their Advantages and Disadvantages

Hong, Soon Kwan; Shin, Hye Jung; Chung, Sung Min; Byun, Sung Wan; Shin, You Ree; Kim, Jin Kyung

Abstract

BACKGROUND AND OBJECTIVES: Uvulopalatopharyngoplasty (UPPP) is performed conventionally with cold knifes and electrocautery under general anesthesia. Although laser-assisted uvulopalatoplasty (LAUP) reduced the need of general anesthesia and bleeding, it still has such problems as severe pain or scar contracture. Coblation electrosurgery is known to be less painful by thermal ablation with low heat. However, comparative studies on the merits and demerits between various surgical techniques are lacking. The aim of this study is to evaluate the advantages and disadvantages of each surgical method by comparing the surgical outcomes between conventional UPPP and Coblation-assisted UPPP (CUPPP), and between LAUP and Coblation-assisted uvulopalatoplasty (CAUP). MATERIALS AND METHOD: Conventional UPPP (N=25) and CUPPP (N=18) were performed on 43 patients with obstructive sleep apnea (OSA), and LAUP (N=21) and CAUP (N=7) on 28 patients with mild OSA or snoring, respectively. Postoperative subjective degrees of apnea, snoring and pain, operation time, amount of intraoperative bleeding and episodes of delayed bleeding were compared between the two groups.
RESULTS
Early postoperative pain and intraoperative bleeding were observed less in the CUPPP group than in the conventional UPPP group. Operation time was shorter and intraoperative bleeding was less in the LAUP group than in the CAUP group. Early postoperative pain was less in the CAUP group than in the LAUP group.
CONCLUSION
Thorough knowledge regarding advantages and limitations of different UPPP or uvulopalatoplasty methods is required for clinicians to make appropriate use of surgical tools.