Efficacy of Uvulopalatopharyngoplasty for Snoring and Obstructive Sleep Apnea: A Systematic Review

Abstract

 

Introduction: Snoring and obstructive sleep apnea are highly prevalent conditions associated with impaired quality of life and increased cardiovascular risk. Uvulopalatopharyngoplasty and its modifications are widely performed surgical procedures, but their efficacy and durability remain debated.

Objectives: To evaluate the efficacy and safety of uvulopalatopharyngoplasty and its variants for the treatment of snoring and obstructive sleep apnea.

Data Synthesis: Five studies were included: one randomized controlled trial, one prospective cohort, one long-term follow-up study, and two case series. Sundman et al. (2022) randomized 93 adults with tonsillar hypertrophy to modified uvulopalatopharyngoplasty or tonsillectomy, showing similar reductions in apnea–hypopnea index (51→28 vs 57→25). MacKay et al. (2013) reported in 48 patients undergoing multilevel surgery (including uvulopalatopharyngoplasty) a decrease in apnea–hypopnea index (23.1→5.6) and Epworth Sleepiness Scale (10.5→5.0). Weitzel et al. documented partial recurrence of symptoms at 8-year follow-up. Fujita et al. (1992) described variable outcomes and frequent relapse after community-based uvulopalatopharyngoplasty. Kamami (1996) reported poor durability of laser-assisted uvulopalatoplasty. Adverse events were generally mild, such as pain and transient dysphagia.

Conclusion: Uvulopalatopharyngoplasty can reduce apnea severity and improve symptoms, particularly within multilevel surgical strategies, but long-term durability is inconsistent. Tonsillectomy alone may be sufficient in selected patients. Evidence remains limited, underscoring the need for further randomized studies.