Practice parameters for the use of laser-assisted uvulopalatoplasty: an update for 2000.

Laser-assisted uvulopalatoplasty (LAUP) is an outpatient surgical procedure which is in use as a treatment for snoring. LAUP also has been used as a treatment for sleep-related breathing disorders, including obstructive sleep apnea. The Standards of Practice Committee of the American Academy of Sleep Medicine reviewed the available literature, and developed these practice parameters as a guide to the appropriate use of this surgery. Adequate controlled studies on the LAUP procedure for sleep-related breathing disorders were not found in peer-reviewed journals. This is consistent with findings in the original practice parameters on LAUP published in 1994. The following recommendations are based on the review of the literature: LAUP is not recommended for treatment of sleep-related breathing disorders. However, it does appear to be comparable to uvulopalatopharyngoplasty (UPPP) for treatment of snoring. Individuals who are candidates for LAUP as a treatment for snoring should undergo a polysomnographic or cardiorespiratory evaluation for sleep-related breathing disorders prior to LAUP and periodic postoperative evaluations for the development of same. Patients should be informed of the best available information of the risks, benefits, and complications of the procedure.

[1]  L. Love,et al.  Unpredictable results of laser assisted uvulopalatoplasty in the treatment of obstructive sleep apnoea , 2000, Thorax.

[2]  C. Guilleminault,et al.  Comparison of Postoperative Pain between Laser-Assisted Uvulopalatoplasty, Uvulopalatopharyngoplasty, and Radiofrequency Volumetric Tissue Reduction of the Palate , 2000 .

[3]  J. Coleman,et al.  Oropharyngeal surgery in the management of upper airway obstruction during sleep. , 1999, Otolaryngologic clinics of North America.

[4]  R. P. Walker,et al.  Early Polysomnographic Findings and Long‐Term Subjective Results in Sleep Apnea Patients Treated With Laser‐Assisted Uvulopalatoplasty , 1999, The Laryngoscope.

[5]  G. Berger,et al.  Histopathologic changes of the soft palate after laser-assisted uvulopalatoplasty. , 1999, Archives of otolaryngology--head & neck surgery.

[6]  J. Jamart,et al.  A new technique for laser‐assisted uvulopalatoplasty: Decision‐tree analysis and results , 1999, The Laryngoscope.

[7]  S. Mickelson,et al.  Short‐term objective and long‐term subjective results of laser‐assisted uvulopalatoplasty for obstructive sleep apnea , 1999, The Laryngoscope.

[8]  L. Wahren,et al.  Patients’ and Cohabitants’ Reports on Snoring and Daytime Sleepiness, 1–8 Years after Surgical Treatment of Snoring , 1999, ORL.

[9]  R. P. Walker,et al.  Laser‐Assisted Uvulopalatoplasty for the Treatment of Mild, Moderate, and Severe Obstructive Sleep Apnea , 1999, The Laryngoscope.

[10]  K. Doghramji,et al.  Efficacy of Laser-Assisted Uvulopalatoplasty in Obstructive Sleep Apnea , 1998, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[11]  A. Dahlqvist,et al.  Persistent dysphagia after laser uvulopalatoplasty: a videoradiographic study of pharyngeal function. , 1998, Acta oto-laryngologica.

[12]  P. Leong,et al.  Laser Assisted Uvulopalatoplasty: an objective evaluation of the technique and results. , 1998, Clinical otolaryngology and allied sciences.

[13]  D. B. Mitchell,et al.  Laser assisted uvulopalatoplasty: six and eighteen month results , 1998, The Journal of Laryngology & Otology.

[14]  B. O'Reilly,et al.  A comparison of conservative, radical and laser palatal surgery for snoring. , 1998, Journal of the Royal College of Surgeons of Edinburgh.

[15]  Po-wen Yang,et al.  Carbon Dioxide Laser Surgery for Snoring: Results in 192 Patients , 1998, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[16]  E. Pinczower Globus sensation after laser-assisted uvulopalatoplasty. , 1998, American journal of otolaryngology.

[17]  J. Coleman Laser-Assisted Uvulopalatoplasty: Long-Term Results with a Treatment for Snoring , 1998, Ear, nose, & throat journal.

[18]  Y. Krespi Office-based surgery of the head and neck , 1998 .

[19]  J. Maw,et al.  Uvulopalatopharyngoplasty versus laser-assisted uvulopalatopharyngoplasty in the treatment of snoring. , 1997, The Journal of otolaryngology.

[20]  G. Postma,et al.  Electrocautery Versus Carbon Dioxide Laser for Uvulopalatoplasty in the Treatment of Snoring , 1997, The Laryngoscope.

[21]  A. Clerk,et al.  A Cost‐Effective and Rational Surgical Approach to Patients With Snoring, Upper Airway Resistance Syndrome, or Obstructive Sleep Apnea Syndrome , 1997, The Laryngoscope.

[22]  Y. Finkelstein,et al.  One-stage laser-assisted uvulopalatoplasty. , 1997, The Journal of otolaryngology.

[23]  Y. Finkelstein,et al.  Uvulopalatopharyngoplasty vs laser-assisted uvulopalatoplasty. Anatomical considerations. , 1997, Archives of otolaryngology--head & neck surgery.

[24]  Y. Tsushima,et al.  Digital fluoroscopy before and after laser uvulopalatopharyngoplasty in obstructive sleep apnea , 1997, Acta radiologica.

[25]  R. P. Walker,et al.  Uvulopalatopharyngoplasty Versus Laser‐Assisted Uvulopalatoplasty for the Treatment of Obstructive Sleep Apnea , 1997, The Laryngoscope.

[26]  T. Takasaka,et al.  Laser-assisted uvulopalatoplasty for habitual snoring without sleep apnea: outcome and complications. , 1997, ORL; journal for oto-rhino-laryngology and its related specialties.

[27]  O. Skatvedt Laser-assisted uvulopalatoplasty: description of the technique and pre- and postoperative evaluation of subjective symptoms. , 1996, ORL; journal for oto-rhino-laryngology and its related specialties.

[28]  D. Ingrams,et al.  CO2 Laser palatoplasty: early results , 1996, The Journal of Laryngology & Otology.

[29]  R. P. Walker,et al.  Laser‐Assisted Uvulopalatoplasty: Postoperative Complications , 1996, The Laryngoscope.

[30]  R. Dickson,et al.  One-stage laser-assisted uvulopalatoplasty. , 1996, The Journal of otolaryngology.

[31]  M. Wareing,et al.  Laser-assisted uvulopalatoplasty: an assessment of a technique , 1996, The Journal of Laryngology & Otology.

[32]  A. Clerk,et al.  Characterization of Postoperative Edema Following Laser‐Assisted Uvulopalatoplasty Using MRI and Polysomnography , 1996, The Laryngoscope.

[33]  Tyers Gf Rules of evidence and clinical recommendations. , 1995 .

[34]  R. P. Walker,et al.  Laser‐assisted uvulopalatoplasty for snoring and obstructive sleep apnea: Results in 170 patients , 1995, The Laryngoscope.

[35]  J. Penek Laser-assisted uvulopalatoplasty ... the cart before the horse. , 1995, Chest.

[36]  G. Zammit,et al.  The efficacy of laser-assisteduvulopalatoplasty in the management of obstructive sleep apnea and upper airway resistance syndrome , 1994 .

[37]  Kamami Yv Outpatient treatment of sleep apnea syndrome with CO2 laser : laser-assisted UPPP , 1994 .

[38]  Kamami Yv Outpatient treatment of snoring with CO2 laser: laser-assisted UPPP. , 1994 .

[39]  Diana B. Petitti,et al.  Meta-Analysis, Decision Analysis, and Cost-Effectiveness Analysis: Methods for Quantitative Synthesis in Medicine , 1994 .

[40]  D. Sackett Rules of evidence and clinical recommendations for the management of patients. , 1993, The Canadian journal of cardiology.

[41]  David M. Eddy,et al.  A Manual for Assessing Health Practices & Designing Practice Policies: The Explicit Approach , 1992 .

[42]  C. Wennmo,et al.  Treatment of snoring--with and without carbon dioxide laser. , 1992, Acta oto-laryngologica. Supplementum.

[43]  J. Szalai,et al.  Are history and physical examination a good screening test for sleep apnea? , 1991, Annals of internal medicine.

[44]  C. Carenfelt Laser Uvulopalatoplasty in Treatment of Habitual Snoring , 1991, The Annals of otology, rhinology, and laryngology.

[45]  Kamami Yv Laser CO2 for snoring. Preliminary results. , 1990 .

[46]  F. Wolf Meta-Analysis: Quantitative Methods for Research Synthesis , 1987 .

[47]  M. Baggish,et al.  The effects of laser smoke on the lungs of rats. , 1987, American journal of obstetrics and gynecology.

[48]  E. Bixler,et al.  Severe obstructive sleep apnea--I: Onset, clinical course, and characteristics. , 1985, Journal of chronic diseases.

[49]  C. Sullivan,et al.  Upper airway closing pressures in snorers. , 1984, Journal of applied physiology: respiratory, environmental and exercise physiology.