MedPath

Vessel Sealing System Uvulopalatoplasty Versus Uvulopalatal Flap

Not Applicable
Conditions
Snoring
Obstructive Sleep Apnea
Interventions
Procedure: Vessel sealing system uvulopalatoplasty (VSSU)
Procedure: Uvulopalatal flap (UPF)
Registration Number
NCT00806637
Lead Sponsor
Chulalongkorn University
Brief Summary

The purpose of this study is to compare vessel sealing system uvulopalatoplasty (VSSU) to the traditional uvulopalatal flap (UPF) in the treatment of sleep-disordered breathing with special regard to intraoperative bleeding, operative time, postoperative pain, postoperative hemorrhage and other adverse effects.

Detailed Description

Uvulopalatopharyngoplasty is one of the common procedures performed by otolaryngologists to treat sleep-disordered breathing patients who have retropalatal obstruction. Intraoperative bleeding is a significant problem which requires hemostasis and causes prolonged operative time. Several different techniques are used to perform this operation, including cold knife, monopolar cautery, coblation, and radiofrequency. Efficacy in hemostasis and tissue trauma from different operative techniques may result in different operative time and different degrees of morbidity including intraoperative blood loss, postoperative pain, postoperative hemorrhage, and velopharyngeal insufficiency (VPI). The vessel sealing system has been widely used in head and neck surgery because of its effectiveness and safety. It was also found quite effective and safe in tonsillectomy procedures, providing excellent hemostasis and minimal tissue trauma.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Patient planned for uvulopalatoplasty for indications of snoring or obstructive sleep apnea
  • Written informed consent form is given from patient
Exclusion Criteria
  • Pregnancy
  • History of bleeding disorders
  • Patient unable to understand evaluation method
  • Patient unable to be contacted via telephone

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1Vessel sealing system uvulopalatoplasty (VSSU)Vessel sealing system uvulopalatoplasty (VSSU) is a new technique for uvulopalatoplasty using a special biclamp forceps for better hemostasis control. Vessel sealing system (VSS) is a bipolar vascular sealing system, with integrated active feedback control. The tissue is grasped and compressed by the handpiece. After the instrument is removed, the seal is visible as a semitransparent window, which can safely be divided. Uvular tip is grasped with an Allis clamp and retracted back toward the soft palate. Excision of the uvula and the redundant part of soft palate is performed by the VSS handpiece. VSS is also used for hemostasis.
2Uvulopalatal flap (UPF)Uvulopalatal flap (UPF) is a standard uvulopalatoplasty technique. Uvulopalatal flap is usually performed as described originally by Powell et al. The soft palate was injected with 5 to 10 milliliters of 1% lidocaine with epinephrine solution. The mucosa, submucosa with glands, and fat on the lingual surface of the uvula and soft palate were removed with a scalpel. Bleeding was controlled with bipolar electrocoagulation. The uvular tip was amputated, and reflected back toward the soft palate, and fixated into its new position with multiple sutures of 3-0 chromic catgut.
Primary Outcome Measures
NameTimeMethod
intraoperative blood losswithin the first 1 hour after surgery starting time
Secondary Outcome Measures
NameTimeMethod
postoperative painwithin the first 14 days after surgery
postoperative bleedingwithin the first 14 days after surgery
operative timewithin the first 1 hour after surgery starting time
postoperative velopharyngeal insufficiencywithin the first 3 months after surgery

Trial Locations

Locations (1)

Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University

🇹🇭

Patumwan, Bangkok, Thailand

© Copyright 2025. All Rights Reserved by MedPath