Verse T
HNO-Abteilung, Asklepios-Klinik Harburg, Eissendorfer Pferdeweg 52, 21075 Hamburg, Deutschland.
HNO. 2008 Nov;56(11):1098-104. doi: 10.1007/s00106-008-1813-z.
Several indications for surgery for obstructive sleep apnea (OSA) have been clarified within the past 3 years. In pediatric OSA, adenotonsillectomy and tonsillotomy are the most common treatments and are highly effective. In adults, nasal surgery facilitates--and sometimes enables--nasally applied continuous positive airway pressure (CPAP) treatment. Today, minimally invasive treatment options for mild OSA are established. Furthermore, several invasive surgical techniques have proven to be efficient in the treatment of mild to moderate OSA. Above an apnea-hypopnea index of 30, surgery should be done only as secondary treatment in cases of CPAP failure or noncompliance. Special forms of OSA, such as laryngeal OSA and supine OSA, must be kept in mind.
在过去3年中,阻塞性睡眠呼吸暂停(OSA)的几种手术指征已得到明确。在小儿OSA中,腺样体扁桃体切除术和扁桃体切开术是最常见的治疗方法,且疗效显著。在成人中,鼻腔手术有助于——有时甚至能使——经鼻持续气道正压通气(CPAP)治疗得以实施。如今,针对轻度OSA的微创治疗方案已确立。此外,几种侵入性手术技术已被证明在治疗轻度至中度OSA方面是有效的。当呼吸暂停低通气指数高于30时,仅在CPAP治疗失败或患者不依从的情况下,手术才应作为二线治疗手段。必须牢记特殊形式的OSA,如喉性OSA和仰卧位OSA。