A new surgical technique versus an old marker: can expansion sphincter pharyngoplasty reduce C-reactive protein levels in patients with obstructive sleep apnea?

The aim of this study was to evaluate the change in serum levels of C-reactive protein (CRP) in patients with obstructive sleep apnea (OSA) before and after expansion sphincter pharyngoplasty (ESP) and continuous positive airway pressure (CPAP) treatment. Fifty-one patients with newly diagnosed OSA were prospectively enrolled in this study. We performed ESP in twenty-three patients in the surgery group and twenty-eight patients were included in the CPAP group. Serum levels of high-sensitivity CRP (hs-CRP) were analyzed by enzyme-linked immunosorbent assays before and 3 months after treatment. The relations between CRP and the apnea hypopnea index (AHI), visual analog scale (VAS), the Epworth Sleepiness Scale (ESS), and saturation parameters were evaluated. Both surgical and CPAP treatments caused significant improvements in the clinical and laboratory parameters. However, only the patients whose postoperative AHI levels improved to final AHI of <5 (n = 6) after ESP, had significant decrease in their serum CRP levels (p = 0.028). CPAP group and the rest of the patients in the surgery group did not show statistically significant difference in CRP levels after treatment. We suggest that the successful surgical treatment for OSA—ESP in this study—, which provides OSA cure, can decrease serum levels of CRP and reduce possible cardiovascular morbidity.