Lateral Pharyngoplasty Reduces Nocturnal Blood Pressure in Patients With Obstructive Sleep Apnea

Abstract

Objectives/HypothesisTo compare the values of 24-hour ambulatory blood pressure monitoring (ABPM) in patients with obstructive sleep apnea (OSA), before and after lateral pharyngoplasty, and to investigate the influence of pre- and post-treatment polysomnographic and anthropometric variations on changes in ABPM. Study DesignProspective study. MethodsArterial blood pressure with 24-hour ABPM and nocturnal polysomnography were measured before and 6 months after surgery in 18 consecutively evaluated adults with OSA at a tertiary center. ResultsA total of 83.3% were normotensive patients. Nocturnal measurements showed a decrease of 5.3 mmHg in mean arterial pressure (MAP; P=.01), 7.4 mmHg in mean arterial systolic pressure (SP; P=.006), and 4.2 mmHg in mean arterial diastolic pressure (DP; P=.03), leading to significant reductions in all 24-hour measurements: 3.6 mmHg in MAP, 4.8 mmHg in SP, and 2.9 mmHg in DP. There were also significant mean reductions in the apnea-hypopnea index (AHI), from 33.5 to 20.9 (P=.02), arousal index, from 31.6 to 16.7 (P=.005), and percentage of total sleep time with oxyhemoglobin saturation<90%, from 10.6% to 0.9% (P=.008). No correlations were noted between the measurements of arterial blood pressure and polysomnographic or anthropometric variations. ConclusionsIn this small case series, lateral pharyngoplasty reduced the values obtained in the 24-hour ABPM due to a significant reduction of blood pressures during sleep in patients with OSA 6 months after surgery. Although the patients presented with reductions in AHI, arousals, and desaturation time, this was not correlated with the improvement in arterial blood pressure. Level of Evidence4 Laryngoscope, 124:311-316, 2014