Woodson B T
Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, USA.
Otolaryngol Head Neck Surg. 2001 Mar;124(3):297-303. doi: 10.1067/mhn.2001.113661.
A tongue suture is postulated to prevent tongue base collapse in obstructive sleep apnea (OSA) and snoring. This procedure uses a permanent tongue base suture to support the pharynx and lessen collapse. This study evaluates 2-month results in 28 OSA and snoring patients.
Forty-three patients have been enrolled in a multi-institutional prospective open enrollment study using the "Repose" bone screw system. Subjects were evaluated using polysomnography measures of general health (SF-36), snoring, and sleep (Epworth Sleepiness Scale and Functional Outcomes of Sleep) performed before and again 2 months after treatment.
In 14 OSA patients (Apnea + Hypopnea (AHI) > 15) and 14 snorers (AHI < 15), no change was noted in sleep architecture or lowest oxygen saturation. AHI decreased in OSA (35.4 +/- 13.7 to 24.5 +/- 14.5, P < 0.00), but not in snorers. AHI decreased in the lateral (16.5 +/- 16.5 to 3.8 +/- 6.4, P < 0.01) but not the supine position. Epworth Sleepiness Scale, Functional Outcomes of Sleep, and snoring scales improved. Snoring decreased but remained bothersome to the bed partner.
A tongue suspension suture partially reduces the respiratory severity of OSA. Small changes are noted in symptoms of sleepiness, snoring, and functional outcomes. Demonstration of efficacy of the technique and device will require further controlled trials.
舌缝术被假定可预防阻塞性睡眠呼吸暂停(OSA)和打鼾时舌根塌陷。该手术使用永久性舌根缝线来支撑咽部并减轻塌陷。本研究评估了28例OSA和打鼾患者术后2个月的结果。
43例患者参与了一项使用“Repose”骨螺钉系统的多机构前瞻性开放入组研究。在治疗前和治疗后2个月,使用多导睡眠图对受试者的总体健康状况(SF-36)、打鼾情况和睡眠状况(Epworth嗜睡量表和睡眠功能结果)进行评估。
在14例OSA患者(呼吸暂停+低通气指数(AHI)>15)和14例打鼾者(AHI<15)中,睡眠结构或最低血氧饱和度无变化。OSA患者的AHI降低(从35.4±13.7降至24.5±14.5,P<0.00),但打鼾者未降低。AHI在侧卧时降低(从16.5±16.5降至3.8±6.4,P<0.01),但仰卧位时未降低。Epworth嗜睡量表、睡眠功能结果和打鼾量表有所改善。打鼾减轻,但仍令同床者烦恼。
舌悬吊缝线可部分降低OSA的呼吸严重程度。在嗜睡、打鼾和功能结果症状方面有小的变化。该技术和装置疗效的证明需要进一步的对照试验。