van den Broek Emke, Richard Wietske, van Tinteren Harm, de Vries Nico
Department of Otorhinolaryngology, Head and Neck Surgery, St. Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.
Eur Arch Otorhinolaryngol. 2008 Nov;265(11):1361-5. doi: 10.1007/s00405-008-0640-x. Epub 2008 Mar 18.
We investigated the outcome of uvulopalatopharyngoplasty (UPPP) combined with radiofrequency thermotherapy of the tongue base (RFTB) in patients with obstructive sleep apnea syndrome (OSAS) with both palatal and retroglossal obstruction, and we compared these results with the results of single level surgery (UPPP). A retrospective cohort study was performed in patients with mild to severe OSAS who underwent UPPP with or without RFTB. Seventy-five patients with both palatal and retroglossal obstruction underwent UPPP, 38 patients without RFTB (group 1) and 37 patients with RFTB (group 2). The outcome of the surgery was measured by both objective success (defined as a reduction of AHI >50% and AHI below 20) and subjective improvement. In group 1 the overall success rate was 42%, and in group 2 49%. Other polysomnographic values (AI, DI, mean SaO2) improved after surgery (not significant). No serious adverse events occurred. Surgical treatment of combined palatal and retroglossal obstruction remains a challenge. Adding RFTB to UPPP results in a mild improvement compared to UPPP alone. Although the addition of RFTB to UPPP seems to result in only a limited improvement, there is no major downside to it. RFTB is well tolerated and safe.
我们研究了悬雍垂腭咽成形术(UPPP)联合舌根射频热凝治疗(RFTB)对同时存在腭部和舌后阻塞的阻塞性睡眠呼吸暂停综合征(OSAS)患者的治疗效果,并将这些结果与单水平手术(UPPP)的结果进行了比较。对接受了有或没有RFTB的UPPP的轻至重度OSAS患者进行了一项回顾性队列研究。75例同时存在腭部和舌后阻塞的患者接受了UPPP,其中38例未接受RFTB(第1组),37例接受了RFTB(第2组)。通过客观成功(定义为呼吸暂停低通气指数(AHI)降低>50%且AHI低于20)和主观改善来衡量手术效果。第1组的总体成功率为42%,第2组为49%。术后其他多导睡眠图值(呼吸暂停指数(AI)、低通气指数(DI)、平均血氧饱和度(SaO2))有所改善(无统计学意义)。未发生严重不良事件。联合腭部和舌后阻塞的手术治疗仍然是一项挑战。与单纯UPPP相比,UPPP联合RFTB可带来轻微改善。虽然UPPP联合RFTB似乎仅带来有限的改善,但并无重大弊端。RFTB耐受性良好且安全。