Application of preventive tracheotomy in surgery of obstructive sleep apnea syndrome

Objective A review of patients with obstructive sleep apnea syndrome (OSAS) undergoing uvulopalatopharyngoplasty (UPPP) or palatopharyngoplasty (PPP) with or without previous tracheotomy was performed to determine the significance and indication of tracheotomy in this process. Methods The paper showed the retrospective case review of study group with OSAS undergoing UPPP/PPP with previous tracheotomy and that of control group without previous tracheotomy. Results The differences between the study and control patients were significant in body mass index (BMI), apnea index (AI), apnea/hypopnea index (AHI), and the lowest oxygen saturation (LOS). Conclusion Results support that tracheotomy can effectively avoid the perioperative fatalities of UPPP/PPP. The indications for tracheotomy before UPPP/PPP are: 1. LOS60%; 2. AHI≥50, AI≥40; 3. severe OSAS complicated with severe hypertension, heart diseases, chronic obstructive pulmonary diseases and cerebrovascular diseases; 4. the symptoms of severe hypoxia; 5. BMI≥30, with short, thick neck, micrognathia, and relative macroglossia; 6. simultaneous nasal operations.