Li Hsueh-Yu, Chen Ning-Hung, Lee Li-Ang, Shu Yu-Hsiang, Fang Tuan-Jen, Wang Pa-Chun
Department of Otolaryngology, Sleep Center, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.
ORL J Otorhinolaryngol Relat Spec. 2004;66(3):119-23. doi: 10.1159/000079330.
There is no consensus on how to quantify the abnormality of upper airway structures in patients with obstructive sleep apnea (OSA). This research aimed to use morphological indicators as clinical predictors to correlate morphological stage and surgical results in OSA patients. One hundred and five patients with OSA received palatopharyngeal surgery, i.e. extended uvulopalatal flap (EUPF). Morphological indicators including modified Mallampati grade (MMP), tonsil size, and body mass index were used to stage OSA patients preoperatively. Change of respiratory disturbance index (RDI) was used to monitor change of sleep apnea events. Success rates were compared among patients of different morphological stages. One year after EUPF, the success rates of EUPF in stage I, II, and III patients were 100, 92.9 and 61.4%, respectively. Change of RDI was significantly correlated with MMP and tonsil size. MMP and tonsil size were predictive of the change of RDI (R(2) = 0.29). Morphological stage may serve as a reliable selection criterion for patients undergoing EUPF surgery and can significantly predict the change of sleep apnea events following EUPF surgery.
对于如何量化阻塞性睡眠呼吸暂停（OSA）患者上气道结构的异常，目前尚无共识。本研究旨在使用形态学指标作为临床预测因子，以关联OSA患者的形态学分期和手术结果。105例OSA患者接受了腭咽手术，即扩展悬雍垂腭瓣（EUPF）。术前使用包括改良马兰帕蒂分级（MMP）、扁桃体大小和体重指数在内的形态学指标对OSA患者进行分期。使用呼吸紊乱指数（RDI）的变化来监测睡眠呼吸暂停事件的变化。比较不同形态学分期患者的成功率。EUPF术后一年，I期、II期和III期患者的EUPF成功率分别为100%、92.9%和61.4%。RDI的变化与MMP和扁桃体大小显著相关。MMP和扁桃体大小可预测RDI的变化（R² = 0.29）。形态学分期可作为接受EUPF手术患者的可靠选择标准，并可显著预测EUPF手术后睡眠呼吸暂停事件的变化。
