Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, VA Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304, USA.
Med Clin North Am. 2010 May;94(3):479-515. doi: 10.1016/j.mcna.2010.02.001.
Obstructive sleep apnea (OSA) is a prevalent condition characterized by repetitive airway obstruction during sleep with associated increased morbidity and mortality. Although CPAP is the preferred treatment, poor compliance is common. Patients intolerant of conventional OSA medical treatment may benefit from surgical therapy to alleviate pharyngeal obstruction. Case series suggest that maxillomandibular advancement has the highest surgical efficacy (86%) and cure rate (43%). Soft palate surgical techniques are less successful, with uvulopalatopharyngoplasty having an OSA surgical success rate of 50% and cure rate of 16%. Further research is needed to more thoroughly assess clinical outcomes (eg, quality of life, morbidity), better identify key preoperative patient and clinical characteristics that predict success, and confirm long-term effectiveness of surgical modalities to treat OSA.
阻塞性睡眠呼吸暂停（OSA）是一种普遍存在的病症，其特征是睡眠期间反复发生气道阻塞，并伴有发病率和死亡率的增加。虽然 CPAP 是首选治疗方法，但依从性差是常见的。无法耐受传统 OSA 药物治疗的患者可能受益于手术治疗以减轻咽阻塞。病例系列研究表明，下颌前伸术具有最高的手术疗效（86%）和治愈率（43%）。软腭手术技术成功率较低，悬雍垂腭咽成形术的 OSA 手术成功率为 50%，治愈率为 16%。需要进一步研究以更全面地评估临床结果（例如，生活质量、发病率），更好地识别预测成功的关键术前患者和临床特征，并确认手术治疗 OSA 的长期效果。
