The Arco-Palato-Uvular Flap.

Oto-Rhino-Laryngologie Chirurg Prim. Mr. sci. med Dr. Vukoje Novak
Novi Sad, Serbia.

The Arco-Palato-Uvular Flap.

This surgical method has been developed by the acknowledged Serbian ENT-surgeon Novak Vukoje. Through the last years this experienced clinician has seen a need for such a procedure which naturally takes place in a segment for patients with snoring, RERA and mild to moderate Sleep Apnea.

It is especially suitable for patients in the group with increased persistent obstructive problems in whom tonsillectomy has been performed earlier, and in the group with broad and fluffy pillars and palatal arches. It is very wisely not recommended if the RDI exceeds 15, the SaO2 is beneath 5% or the BMI surpasses 32 kg/m2.

Besides being easy to perform, though usually under general anesthesia, it also takes into account the various pitfalls occurring in other procedures, often leading to a poor success rate. These are such as postoperative palatal scarring and fibrosis with concomitant narrowing and too much stiffening, rather increasing the preoperative afflictions than solving them. Additionally this method results in an important remaining increased transversal oropharyngeal diameter, statistically shown to be of great importance regarding this disease. By preservation of the great bulk of midline uvulo-palatal tissue, the most unfavorable side effect, nasal regurgitation, is avoided. This makes it possible to postoperatively adjust to CPAP treatment as well.

Several years of follow up results have proven the Arco-Palato-Uvular Flap to be a well tolerated, efficient and recommendable procedure for the defined target group.

Bergen, Norway, May 18^th. 2008.

Magne Tvinnereim MD., Ph.D.

Director, EuroSleep ltd.

Member of the Norwegian Competence Center for Sleep Disorderes.

REZ ZA MIRAN SAN

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