Surgery for the treatment of obstructive sleep apnoea

Article type
Authors
Bridgman SA, Dunn KM
Abstract
Introduction/Objective: To review the current efficacy of surgery in the treatment of obstructive sleep apnoea (OSA).

Methods: Systematic review searching for relevant randomised controlled trials involving electronic searching of the Cochrane Airways Group's Register of Trials, MEDLINE, EMBASE, CINAHL, manual searching of reference lists of identified reviews and major studies and personal contact with experts in the fields of respiratory and sleep medicine and ENT surgery. The identified studies were independently assessed for inclusion by two reviewers, using specific inclusion criteria.

Results: The electronic search identified 594 abstracts and the manual searching identified a further 37 articles. No published randomised controlled trials have been identified to date. Notification has been received of a possible relevant study, which is as yet unpublished and in a foreign language; the reviewers are awaiting further information regarding this. A large number of descriptive studies, mainly of poor quality, were also identified.

Discussion: There is no trial based evidence to guide clinicians in the surgical treatment of OSA. There are a range of different surgical interventions aimed at relieving the airways narrowing or collapse which occurs in OSA. A problem for future trials is the lack of standardised definitions of OSA and its sub-categories, whose diagnosis depends on a combination of symptoms, and physiological and anatomical assessment. Standardisation of outcome measures will also be required.