Kyrmizakis Dionysios E, Chimona Theognosia S, Papadakis Chariton E, Bizakis John G, Velegrakis George A, Schiza Sofia, Siafakas Nikolaos M, Helidonis Emmanuel S
ENT Department, University Hospital, Heraklion, Crete, Greece.
J Otolaryngol. 2003 Jun;32(3):174-9. doi: 10.2310/7070.2003.40423.
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).
Prospective, nonrandomized, nonblinded assessment of outcomes after LAUP in patients suffering from benign habitual snoring and/or mild OSAS.
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).
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.
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.
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。
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。
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。
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。
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。