Li Hsueh-Yu, Wang Pa-Chun, Hsu Chung-Yao, Lee Shee-Wei, Chen Ning-Hung, Liu Shih-An
Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Acta Otolaryngol. 2005 Mar;125(3):298-303. doi: 10.1080/00016480410022831.
Our data indicate that surgical outcomes in a simultaneous surgery group were equivalent to those in a staged surgery group. The simultaneous type of surgery was more cost-effective in terms of total hospitalization expenses.
To compare the outcomes of two types of combined nasal-palatopharyngeal surgery (simultaneous and staged) for the treatment of obstructive sleep apnea (OSA).
A total of 85 consecutive patients were enrolled in the study. All patients had OSA and its associated symptoms, were type I according to the Fujita classification, stage 1 or 2 according to the Friedman classification and had nasal obstruction with nasal septal deviation. A modified form of uvulopalatopharyngoplasty (extended uvulopalatal flap surgery) and septomeatoplasty were used to correct upper airway abnormalities. Patients chose to have either a simultaneous (n = 55) or staged (n = 30) type of operation. All patients underwent overnight polysomnography at baseline and < or = 6 months after completion of the operations. Surgical results (reduction of OSA), patient satisfaction, complications and hospitalization expenses were compared between the two groups.
The two groups comprised body mass index- and respiratory disturbance index (RDI)-matched cohorts (p > 0.05). Postoperative decreases in RDI were significant in both groups (p < 0.001), and postoperative RDI was indistinguishable between the two groups (p = 0.77). Incidences of surgical complications, including tonsillar bleeding, nasal septal hematoma, nasal regurgitation and the sensation of a lump in the throat, were similar in the two groups (p = 0.35). The simultaneous surgery group incurred lower total hospitalization expenses than the staged surgery group (p < 0.001).
我们的数据表明，同期手术组的手术效果与分期手术组相当。就总住院费用而言，同期手术类型更具成本效益。
比较两种联合鼻腭咽手术（同期和分期）治疗阻塞性睡眠呼吸暂停（OSA）的效果。
共纳入85例连续患者进行研究。所有患者均患有OSA及其相关症状，根据藤田分类为I型，根据弗里德曼分类为1期或2期，且伴有鼻中隔偏曲导致的鼻塞。采用改良的悬雍垂腭咽成形术（延长悬雍垂腭瓣手术）和鼻中隔鼻甲成形术来纠正上气道异常。患者选择接受同期手术（n = 55）或分期手术（n = 30）。所有患者在基线时以及手术完成后≤6个月接受整夜多导睡眠图检查。比较两组的手术结果（OSA减轻情况）、患者满意度、并发症和住院费用。
两组患者的体重指数和呼吸紊乱指数（RDI）匹配（p > 0.05）。两组术后RDI均显著下降（p < 0.001），且两组术后RDI无显著差异（p = 0.77）。两组手术并发症发生率相似，包括扁桃体出血、鼻中隔血肿、鼻反流和咽部异物感（p = 0.35）。同期手术组的总住院费用低于分期手术组（p < 0.001）。
