Hessel Natascha S, de Vries Nico
Department of Otorhinolaryngology and Head and Neck Surgery, Saint Lucas Andreas Hospital, Amsterdam, The Netherlands.
Eur Arch Otorhinolaryngol. 2003 Feb;260(2):91-5. doi: 10.1007/s00405-002-0511-9. Epub 2002 Sep 4.
We subjectively and objectively evaluated 136 patients with socially unacceptable snoring (SUS) or obstructive sleep apnoea syndrome (OSAS) treated with uvulopalatopharyngoplasty (UPPP) after a diagnostic workup by sleep registration (polysomnography, PSG) and sleep endoscopy. Of the 136 patients, there were 88 with OSAS and 48 with SUS. The results of the procedure were considered subjectively to be an improvement in 38 (79%) of the SUS patients and in 74 (84%) of the patients with OSAS. In 36 (40%) of the 88 patients with OSAS, repeating PSG postoperatively was considered unnecessary because of obvious improvement. Of the 52 patients with a measurement after UPPP, a decrease in the apnoea hypopnoea index (AHI) was found in 38 (73%; median decrease: 48%), and AHI dropped below 20 in 32 (62%). The apnoea index (AI) was available in 49 (56%) patients and was reduced in 31 (63%; median decrease: 73%). An overall positive result in the 88 patients with OSAS (combining available data on subjective and objective results) was therefore found in 61 (69%; positive subjective result and AHI <15) or 71 (81%; positive subjective result and decrease in AHI), respectively, depending on the definition. We conclude that after diagnostic workup by sleep registration and sleep endoscopy, the success rate of UPPP increases as compared to historical controls.
我们对136例患有社会不可接受性打鼾(SUS)或阻塞性睡眠呼吸暂停综合征(OSAS)的患者进行了主观和客观评估,这些患者在经过睡眠登记(多导睡眠图,PSG)和睡眠内镜检查的诊断性检查后接受了悬雍垂腭咽成形术(UPPP)治疗。在这136例患者中,有88例患有OSAS,48例患有SUS。主观上认为该手术的结果是,SUS患者中有38例(79%)病情改善,OSAS患者中有74例(84%)病情改善。在88例OSAS患者中,有36例(40%)术后因明显改善而被认为无需重复进行PSG检查。在52例接受UPPP术后测量的患者中,38例(73%;中位数下降:48%)的呼吸暂停低通气指数(AHI)下降,32例(62%)的AHI降至20以下。49例(56%)患者有呼吸暂停指数(AI)数据,其中31例(63%;中位数下降:73%)的AI降低。因此,根据定义,88例OSAS患者的总体阳性结果分别为61例(69%;主观结果为阳性且AHI<15)或71例(81%;主观结果为阳性且AHI下降)。我们得出结论,在经过睡眠登记和睡眠内镜检查的诊断性检查后,与历史对照相比,UPPP的成功率有所提高。