The objective of this randomized, controlled study is to compare intraoperative blood loss,
operative time,
postoperative pain and postoperative adverse effects (
bleeding,
velopharyngeal insufficiency and others) between vessel sealing system uvulopalatoplasty (VSSU) and uvulopalatal flap (UPF). The study was conducted at the Department of Otolaryngology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. 31 subjects with
sleep-disordered breathing and obstruction at the retropalatal level were enrolled consecutively. Intervention was randomized by mixed block randomization into 2 groups (UPF, VSSU). Stratification was also done by the presence or absence of concomitant
tonsillectomy. Measured outcomes, which were blinded to patients and outcome assessor, were intraoperative blood loss,
operative time,
postoperative pain, postoperative
bleeding, postoperative
velopharyngeal insufficiency and other adverse effects. Median (IQR) of intraoperative blood loss from VSSU and UPF was 0.00 (0.00-1.00) and 6.00 (1.25-12.75) ml (p < 0.001). Median (IQR) of
operative time from VSSU and UPF was 3.50 (3.00-5.00) and 15.00 (12.25-18.00) min (p < 0.001). There was significantly less
pain in VSSU group on operative day (p = 0.001) and postoperative day 1 (p = 0.009). However, no significant difference of
pain on postoperative day 2 to day 14 (p = 0.055-0.983) between both groups. Regarding postoperative
bleeding, 1 case of immediate
bleeding in UPF group and 1 case of delayed
bleeding in VSSU group were found in this study. Postoperative
velopharyngeal insufficiency and other adverse effects were not found in both groups. In conclusion, VSSU was better than UPF in terms of less intraoperative blood loss, less
operative time and less
pain in early postoperative period. Postoperative
velopharyngeal insufficiency and other adverse effects were not found in both groups.