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激光辅助悬雍垂腭成形术治疗打鼾及轻度阻塞性睡眠呼吸暂停综合征。

Laser-assisted uvulopalatoplasty for the treatment of snoring and mild obstructive sleep apnea syndrome.

作者信息

Kyrmizakis Dionysios E, Chimona Theognosia S, Papadakis Chariton E, Bizakis John G, Velegrakis George A, Schiza Sofia, Siafakas Nikolaos M, Helidonis Emmanuel S

机构信息

ENT Department, University Hospital, Heraklion, Crete, Greece.

出版信息

J Otolaryngol. 2003 Jun;32(3):174-9. doi: 10.2310/7070.2003.40423.

Abstract

OBJECTIVE

To determine the efficacy of the laser-assisted uvulopalatoplasty (LAUP) procedure on snoring and Apnea-Hypopnea-Index (AHI) improvement in patients with snoring and mild obstructive sleep apnea syndrome (OSAS).

STUDY DESIGN

Prospective, nonrandomized, nonblinded assessment of outcomes after LAUP in patients suffering from benign habitual snoring and/or mild OSAS.

METHODS

Fifty-nine patients with habitual snoring and 25 patients with mild OSAS underwent LAUP (6 of them underwent simultaneous classic tonsillectomy and 20 carbon-dioxide laser tonsillotomy). All patients and their bed partners completed pre- and post-treatment questionnaires ranking snoring, whereas the patients with mild OSAS underwent postoperative polysomnography (PSG).

RESULTS

During a 6-month to 5-year follow-up (mean 40 months), 91.5% of the patients with habitual snoring reported significant short-term improvement based on post-treatment questionnaires, whereas 79.7% reported long-term subjective improvement. Nineteen of 25 patients (76%) with mild OSAS reported significant improvement of snoring based on posttreatment questionnaires. According to the postoperative PSG, only 2% showed a worse AHI, whereas 60% showed reduction of the AHI to < or = 5. Eight patients (32%) showed little or no improvement of AHI.

CONCLUSIONS

LAUP, in combination with carbon-dioxide laser tonsillotomy in some cases, is a safe, cost-effective, outpatient procedure for the treatment of many cases of habitual snoring and mild OSAS when preceded by careful selection of the candidates.

摘要

目的

确定激光辅助悬雍垂腭咽成形术(LAUP)对打鼾患者及改善轻度阻塞性睡眠呼吸暂停低通气综合征(OSAS)患者打鼾和呼吸暂停低通气指数(AHI)的疗效。

研究设计

对患有良性习惯性打鼾和/或轻度OSAS的患者在LAUP术后进行前瞻性、非随机、非盲法结局评估。

方法

59例习惯性打鼾患者和25例轻度OSAS患者接受了LAUP(其中6例同时进行了经典扁桃体切除术,20例进行了二氧化碳激光扁桃体切除术)。所有患者及其同床伴侣均完成了治疗前后关于打鼾程度的问卷调查,而轻度OSAS患者术后接受了多导睡眠图(PSG)检查。

结果

在6个月至5年的随访期内(平均40个月),91.5%的习惯性打鼾患者根据治疗后问卷调查显示短期有显著改善,而79.7%的患者报告有长期主观改善。25例轻度OSAS患者中有19例(76%)根据治疗后问卷调查显示打鼾有显著改善。根据术后PSG检查,只有2%的患者AHI恶化,而60%的患者AHI降至≤5。8例患者(32%)AHI改善甚微或无改善。

结论

LAUP联合二氧化碳激光扁桃体切除术在某些情况下,对于经过仔细筛选的许多习惯性打鼾和轻度OSAS病例来说,是一种安全且经济有效的门诊治疗方法。

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