Sheng Jianfei, Luo Zhihong, Kong Yonggang, Jiang Yang
Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2007 Dec;21(24):1127-8.
To explore the effect of a comprehensive surgical approach of hyoid suspension with Repose system plus uvulopalatopharyngoplasty (UPPP) on the treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS).
Twelve patients with severe OSAHS (AHI > 40) diagnosed by polysomnography, were determined for the obstruction in both the velo-pharyngeal and the hypopharynx by preoperative physical examination, fiberoptic pharyngo-laryngoscopy. Two cases were given continuous airway pressure via nose, seven days before operation and then were performed hyoid suspension plus UPPP. The follow up was 3 months postoperatively. The pair T test was used to compare the preoperative and postoperative results by SPSS11.0 for windows.
At postoperative 3 month, there were statistically significance between preoperative and postoperative measurement in all. Mean AHI decreased from preoperative 69.28 +/- 6.50 to postoperative 19.77 +/- 9.23, lowest mean oxygen saturation increased from 65.25 -/+ 3.14 to 90.17 +/- 2.86. Snoring and sleep apnea disappeared or lessened, with the disappearance or decrease of lethargy at daytime. No severe complication occurred.
Comprehensive surgical approach of hyoid suspension with Repose system plus UPPP is effective surgical approach for patients with severe OSAHS who suffered from oropharyngeal and hypopharyngeal obstruction in short- term result.
探讨采用Repose系统舌骨悬吊术联合悬雍垂腭咽成形术(UPPP)的综合手术方法治疗重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的效果。
选取12例经多导睡眠图诊断为重度OSAHS(呼吸暂停低通气指数>40)的患者,术前通过体格检查、纤维喉镜检查确定其腭咽和下咽均存在阻塞。其中2例在手术前7天给予经鼻持续气道正压通气,然后行舌骨悬吊术联合UPPP。术后随访3个月。采用SPSS11.0 for windows软件进行配对t检验,比较术前和术后的结果。
术后3个月时,各项术前和术后测量指标之间均有统计学意义。平均呼吸暂停低通气指数从术前的69.28±6.50降至术后的19.77±9.23,最低平均血氧饱和度从65.25±3.14升至90.17±2.86。打鼾和睡眠呼吸暂停消失或减轻,白天嗜睡症状消失或减轻。未发生严重并发症。
对于患有口咽和下咽阻塞的重度OSAHS患者,采用Repose系统舌骨悬吊术联合UPPP的综合手术方法在短期内是有效的手术方法。