The effects of anterior palatoplasty on floppy eyelid syndrome patients with obstructive sleep apnea

Objectives/hypothesis: To investigate the effects of anterior palatoplasty on the presence and stage of floppy eyelid syndrome (FES) among patients diagnosed with mild or moderate obstructive sleep apnea (OSA) according to the apnea-hypopnea index (AHI).

Study design: Prospective controlled trial.

Methods: Those patients whose AHI scores were between 5 and 30 according to full-night polysomnography were included in the study. The patients in whom anterior palatoplasty was performed were included in the study group, whereas those refusing surgery comprised the control group. All patients were evaluated for the presence of FES. The sleep studies were repeated after the third postoperative month, and the results were statistically compared.

Results: Sixty-two patients were included in the study. Thirty-five patients who were treated with anterior palatoplasty comprised the study group, and 27 patients were included in the control group. In the surgically treated group, 60% (n = 21) had FES, whereas 55.5% (n = 15) of the control group had FES (P = .798). In the surgically treated group, the FES ratio decreased to 25.7% (n = 9) after the third postoperative month (P = .007). In surgically successful cases, the preoperative-postoperative oxygen desaturation index and preoperative-postoperative lowest oxygen saturation values were 11.755% ± 9.037% and 6.77% ± 5.362% (P = .04), and 86.1% ± 3.89% and 87.8% ± 2.85%, respectively (P = .124). These values were 12.166% ± 5.767% and 14.780% ± 9.924% (P = .385), and 86.13% ± 4.18% and 85.26% ± 4.26%, respectively (P = .579), in patients who underwent unsuccessful surgery.

Conclusions: FES presence and stages were decreased following successful anterior palatoplasty surgery. This effect may have resulted from the correction of tissue hypoxia, which is common in the pathophysiology of both OSA and FES.

Level of evidence: 2b Laryngoscope, 126:2171-2175, 2016.