[Analysis of the difference of therapeutic effect and predictive factors between postural and non-postural OSA after modified uvulopalatopharyngoplasty].

Objective: To analyze the factors influencing the outcome of uvulopalatopharyngoplasty in positional obstructive sleep apnea（POSA） and non-positional OSA（NPOSA） patients, and to explore the differences between the two groups. Methods: The data of 101 patients with obstructive sleep apnea who received treatment from November 2020 to November 2023 were retrospectively analyzed. Among them, 45 positional patients（POSA group） and 56 non-positional patients（NPOSA group）, who underwent overnight polysomnography were included. The upper airway（UA） anatomy was evaluated by three-dimensional computer tomography（3D-CT）. All patients received revised uvulopalatopharyngoplasty with uvula preservation and were followed using polysomnography for at least three months postoperatively. Results: The overall effective rate was 55.45%. The surgical success rate in POSA undergoing UPPP was higher than NPOSA（POSA 30/45, 66.7% versus NPOSA 26/56, 46.4%, P =0.042）. The H-UPPP effect of POSA was negatively correlated with the minimum lateral airway of the Velopharyngeal airway（ r =-0.505, P <0.001）, the minimum lateral airway of the glossopharyngeal airway（ r =-0.474, P =0.001） and the minimum cross-sectional area（ r =-0.394, P =0.007）. Logistic analysis showed that minimal lateral airway of the glossopharynxgeum（mLAT）（ OR 0.873; 95% CI 0.798-0.955, P =0.003） was a significant predictor for surgical outcomes among POSA patients. In NPOSA, age（ OR 0.936; 95% CI 0.879-0.998, P =0.042） was a significant predictor for surgical outcomes. Conclusion: The effect of H-UPPP was higher in POSA than in NPOSA. The width of glossopharyngeal mLAT was an important predictor of POSA efficacy. Age was a predictor of NPOSA efficacy.