Zhang Qingquan, Zhang Tianzhen, Li Shufeng, Su Yan, Luan Jian'gang, Yao Yujian, Zhang Hua, Ma Xianying
Department of Otorhinolaryngology, Yuhuangding Hospital, Yantai, Shandong 264000, China.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2002 Dec;37(6):409-11.
To study the effect and operative method of UPPP and tongue base operation for the severe OSAHS at Velo- and tongue-pharyngeal obstruction.
26 cases who were diagnosed as severe OSAHS with Velo- and tongue-pharyngeal obstruction by Muller's maneuver were treated surgically by UPPP and tongue base operation. The tongue base operation included fusiform incision or rhomboid incision in the middle of tongue base by laser or electrotome. 4 cases received tongue base lateral incision and advancement fixation. 2 cases underwent tracheotomy before the operation. 20 cases underwent tracheotomy during operation.
The 6-month, 1-year and 3-year responders are 100%, 84.6% and 76.9% respectively. The introcession of the tongue base incision were repaired in four cases. After 1-2 years, the cases with lateral incision on the tongue base with advancement fixation had temporary aspiration after the operation and recovered through practice.
The polysomnography (PSG) was essential to OSAHS and especially to severe OSAHS. Muller's maneuver is important in locating the obstructive sites of OSAHS. The stitching is essential to the cases after fusiform incision or rhomboid incision of tongue base. The combination of UPPP and tongue base operation is important for OSAHS treatment. The combined treatment of OSAHS could have a better results.
探讨悬雍垂腭咽成形术（UPPP）联合舌根手术治疗腭咽及舌根平面阻塞型重度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的疗效及手术方法。
对26例经Muller动作诊断为腭咽及舌根平面阻塞型重度OSAHS患者行UPPP联合舌根手术治疗。舌根手术包括采用激光或电刀在舌根中部行梭形切口或菱形切口，4例行舌根侧切口并前徙固定术。2例术前气管切开，20例术中气管切开。
术后6个月、1年及3年有效率分别为100%、84.6%及76.9%。4例舌根切口内陷者行修复术。舌根侧切口并前徙固定术患者术后1~2年出现暂时性误吸，经训练后恢复。
多导睡眠图（PSG）对OSAHS尤其是重度OSAHS至关重要。Muller动作对确定OSAHS阻塞部位具有重要意义。舌根梭形或菱形切口术后缝合至关重要。UPPP联合舌根手术对OSAHS治疗具有重要意义，联合治疗OSAHS可取得较好疗效。
