Chen Shi-Cai, Shi Song, Zheng Hong-Liang, Chen Dong-Hui, Zhu Min-Hui, Liu Fei, Tang Hai-Hong, Wang Kai
Department of Otorhinolaryngology Head and Neck Surgery, Changhai Hospitai, Second Military Medical University, Shanghai 200433, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2009 Oct;44(10):815-8.
To evaluate the efficacy and reliability of genioglossus advancement and hyoid suspension with non-trephine technic (GAHM) and uvulopalatopharyngoplasty (UPPP) for surgical obstructive sleep apnea-hypopnea syndrome treatment.
Twenty-six patients (4 female and 22 male) were classified as moderate and severe cases in terms of apnea hypopnea index (AHI) and Friedman classification in the present study. All cases patients underwent genioglossus advancement and hyoid suspension with non-trephine technic Uvulopalatopharyngoplasty UPPP. Pre- and postoperative polysomnography and Epworth sleepiness scale were performed to assess the therapeutic outcomes.
The whole operation time ranged from 120-180 minutes. The average amount of bleeding in genioglossus advancement was about 50-100 ml. There were no severe complications during and after the operation. All the cases were followed up to one year. After surgery, AHI was decreased in both group cases, (42.9 +/- 6.6 vs 16.2 +/- 5.7) in the severe group, and 21.3 +/- 4.4 vs 11.3 +/- 5.2 (x(-) +/- s) in the moderate group. With success defined as AHI decreased by more than 50 per cent after surgery, the total success rate in moderate and severe group was 83.3% and 91.7%, respectively (P < 0.01). Furthermore, the success rate of the moderate group was higher than those of the severe group (P < 0.01).
GAHM combined with UPPP may be beneficial for the moderate and severe OSAHS patients with oropharyngeal and hypopharyngeal obstruction.
评估采用非环锯技术的颏舌肌前移和舌骨悬吊术(GAHM)联合悬雍垂腭咽成形术(UPPP)治疗阻塞性睡眠呼吸暂停低通气综合征的疗效和可靠性。
本研究中,26例患者(4例女性,22例男性)根据呼吸暂停低通气指数(AHI)和弗里德曼分类法被归类为中重度病例。所有病例均接受了采用非环锯技术的颏舌肌前移和舌骨悬吊术以及悬雍垂腭咽成形术(UPPP)。术前和术后均进行多导睡眠图和爱泼华嗜睡量表检查以评估治疗效果。
整个手术时间为120 - 180分钟。颏舌肌前移术中平均出血量约为50 - 100毫升。手术期间及术后均未出现严重并发症。所有病例均随访一年。术后,两组病例的AHI均降低,重度组为(42.9±6.6对16.2±5.7),中度组为21.3±4.4对11.3±5.2(x(-)±s)。若将手术成功定义为术后AHI降低超过50%,则中度和重度组的总成功率分别为83.3%和91.7%(P < 0.01)。此外,中度组的成功率高于重度组(P < 0.01)。
GAHM联合UPPP可能对患有口咽和下咽阻塞的中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者有益。