Gillespie M Boyd, Smith Jacob E, Clarke Joseph, Nguyen Shaun A
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425-5500, USA.
Otolaryngol Head Neck Surg. 2009 Mar;140(3):363-8. doi: 10.1016/j.otohns.2008.12.027.
Determine patient factors associated with the success and complications of using the Pillar palatal implants for snoring management.
Retrospective series of 79 consecutive adult patients receiving Pillar implants for snoring management between January 2005 and December 2007. Multiple regression analysis was used to determine factors associated with initial and final bed partner satisfaction with the snoring result, and factors associated with Pillar-related complications.
A total of 64 of 79 (81%) bed partners reported snoring improvement in patients after initial Pillar implantation; however, only 31 (39%) were satisfied with the level of reduction. Following secondary procedures, the number of satisfied bed partners improved to 52 (66%). Factors associated with final bed partner satisfaction included lower initial apnea-hypopnea index (AHI) (P = 0.029), Friedman tongue position I or II (P = 0.008), and shorter follow-up time (P = 0.001). Sixteen patients (20%) experienced procedure-related complications. Factors associated with Pillar complications included female gender (P = 0.001) and placement under general anesthesia (P = 0.009).
Initial AHI values and tongue position scores are important determinants of final snoring success. Pillar implants placed in women and under general anesthesia may have a higher risk of poor placement and extrusion.
确定与使用腭部支柱植入物治疗打鼾的成功率和并发症相关的患者因素。
回顾性系列研究,纳入了2005年1月至2007年12月期间连续79例接受腭部支柱植入物治疗打鼾的成年患者。采用多元回归分析来确定与配偶对打鼾治疗初始及最终效果的满意度相关的因素,以及与腭部支柱相关并发症相关的因素。
79例患者中,共有64例(81%)的配偶报告患者在初次植入腭部支柱后打鼾情况有所改善;然而,只有31例(39%)对打鼾减轻程度感到满意。在进行二次手术后,感到满意的配偶数量增至52例(66%)。与配偶最终满意度相关的因素包括较低的初始呼吸暂停低通气指数(AHI)(P = 0.029)、弗里德曼舌位I或II级(P = 0.008)以及较短的随访时间(P = 0.001)。16例患者(20%)出现了与手术相关的并发症。与腭部支柱并发症相关的因素包括女性性别(P = 0.001)和在全身麻醉下植入(P = 0.009)。
初始AHI值和舌位评分是最终打鼾治疗成功的重要决定因素。在女性患者和全身麻醉下植入腭部支柱可能有更高的植入不佳和脱出风险。