Sezen Ozan Seymen, Aydin Ercan, Eraslan Gülüzar, Haytoglu Suheyl, Coskuner Temel, Unver Seref
Kartal Dr. Lutfi Kirdar Research and Training Hospital, Otolaryngology Head and Neck Surgery Department, Istanbul, Turkey.
Auris Nasus Larynx. 2011 Aug;38(4):487-94. doi: 10.1016/j.anl.2010.11.013. Epub 2011 Jan 26.
To investigate the radiologic and polysomnographic success in opening the airway using a tongue base suspension procedure alone or in combination with uvulopalatal flap in obstructive sleep apnea syndrome (OSAS) patients.
This study was conducted in 20 patients with moderate or severe OSAS in a prospective manner. The tongue base suspension technique alone or with a uvulopalatal flap (UPF) technique was applied. Magnetic resonance imaging (MRI) scans of patients obtained during the preoperative period and at the 5th week of the postoperative period were compared. Changes in pain and swallowing difficulties were assessed. Polysomnography (PSG) was applied at the 12th postoperative month, and body mass index (BMI) and Epworth sleepiness scale (ESS) values were determined. The degree of satisfaction relative to the surgery was assessed with 4 questions.
Preoperative apnea-hypopnea index (AHI) level was found to be 24.55±9.87, whereas postoperative AHI level was 12.40±9.87 (P<0.01). The success rate was determined to be 60%. Preoperative ESS values were 13.90±2.67 and were reduced to 6.55±3.13 postoperatively (P<0.01), and the preoperative posterior airway space (PAS) level was 10.08±1.23, which was increased to 11.64±1.46 postoperatively (P<0.01). Visual analog scale (VAS) values for swallowing difficulty were 8.62 at day 1 and decreased to 3.98 at day 7. The VAS values for pain were 9.14 at day 1, but were reduced to 4.18 at day 7.
Patients with OSAS who have hypertrophy of the tongue base may safely receive a tongue base suspension procedure, which is a minimally invasive method. The postoperative hospital stay is short and the success rate is high, as shown with both PSG and MRI.
探讨在阻塞性睡眠呼吸暂停综合征（OSAS）患者中，单独使用舌根悬吊术或联合悬雍垂腭瓣手术开放气道的放射学和多导睡眠图检查结果。
本研究前瞻性纳入20例中重度OSAS患者。采用单独的舌根悬吊技术或联合悬雍垂腭瓣（UPF）技术。比较患者术前及术后第5周的磁共振成像（MRI）扫描结果。评估疼痛和吞咽困难的变化。术后第12个月进行多导睡眠图（PSG）检查，测定体重指数（BMI）和爱泼华嗜睡量表（ESS）值。通过4个问题评估患者对手术的满意度。
术前呼吸暂停低通气指数（AHI）水平为24.55±9.87，术后AHI水平为12.40±9.87（P<0.01）。成功率为60%。术前ESS值为13.90±2.67，术后降至6.55±3.13（P<0.01），术前气道后间隙（PAS）水平为10.08±1.23，术后升至11.64±1.46（P<0.01）。吞咽困难的视觉模拟量表（VAS）值在术后第1天为8.62，术后第7天降至3.98。疼痛的VAS值在术后第1天为9.14，但术后第7天降至4.18。
舌根肥大的OSAS患者可安全接受舌根悬吊术，这是一种微创方法。PSG和MRI检查均显示，术后住院时间短且成功率高。
