Second Clinic of Otolaryngology, Head and Neck Surgery, Ministry of Health Istanbul Training and Research Hospital, Istanbul, Turkey.
Laryngoscope. 2011 May;121(5):1112-6. doi: 10.1002/lary.21731.
OBJECTIVES/HYPOTHESIS: To evaluate the impact of the uvular length on the efficacy of palatal implants in primary snoring.
Prospective case series, tertiary hospital, snoring and respiratory sleep disorders center.
Forty subjects with inserted palatal implants and diagnoses of primary snoring were included. All met the inclusion criteria of age >18 years, body mass index <30, apnea-hypopnea index <5, tonsil grade <3, soft-palate length >25 mm, and Friedman tongue position <3 following clinical, endoscopic, and polysomnographic evaluation. Epworth sleepiness scale (ESS) and the snoring-intensity visual analogue scale (VAS) were recorded before and 9 months after the implant. Four subjects with extruded implants were excluded; the remaining 36 subjects were divided into two groups, Group I and Group II, with uvular lengths of ≤15 mm and >15 mm, respectively. The study assessed and compared subjective outcome measures including the partner's satisfaction (PS), partner's reported improvement (PRI), 50% VAS and ESS reduction, and subjective success (SS) defined as 50% VAS reduction. The Student t test, χ(2) test, and logistic regression models were used for statistical evaluation.
SS (50% VAS reduction), PS, PRI, and 50% ESS reduction were significantly higher in Group I (P < .001, P = .0257, P = .027, P < .001). The overall SS, PRI, PS, and 50% ESS reduction were 33%, 78%, 50%, and 50%, respectively. The uvular length was found to be the determinant factor of SS (P = .005; odds ratio = 0.75), PRI (P = .039; odds ratio = 0.83), and 50% ESS reduction (P = .038; odds ratio: 0.84) following implant insertion through stepwise logistic regression analysis.
Excess uvular length (>15 mm) is an important anatomic feature decreasing the efficacy of palatal implants in snoring, and additional measures, such as uvulectomy, should be considered simultaneously for better outcomes (level 4).
目的/假设：评估悬雍垂长度对腭植入物治疗原发性打鼾疗效的影响。
前瞻性病例系列，三级医院，打鼾和呼吸睡眠障碍中心。
纳入 40 例接受腭植入物治疗且诊断为原发性打鼾的患者。所有患者均符合以下纳入标准：年龄＞18 岁，体重指数＜30，呼吸暂停低通气指数＜5，扁桃体分级＜3，软腭长度＞25mm，经临床、内镜和多导睡眠图评估后，弗利德曼舌位＜3。记录植入物前和植入物后 9 个月的 Epworth 嗜睡量表（ESS）和打鼾强度视觉模拟量表（VAS）。4 例因植入物突出而被排除；其余 36 例患者根据悬雍垂长度分为两组，I 组悬雍垂长度≤15mm，II 组悬雍垂长度＞15mm。研究评估并比较了包括配偶满意度（PS）、配偶报告的改善（PRI）、50% VAS 和 ESS 降低、定义为 50% VAS 降低的主观成功（SS）在内的主观结果指标。采用 Student t 检验、χ(2)检验和逻辑回归模型进行统计学评估。
I 组 50% VAS 降低的 SS、PS、PRI 显著更高（P＜0.001，P=0.0257，P=0.027，P＜0.001）。总体 SS、PRI、PS 和 50% ESS 降低分别为 33%、78%、50%和 50%。通过逐步逻辑回归分析发现，悬雍垂长度是 SS（P=0.005；优势比=0.75）、PRI（P=0.039；优势比=0.83）和植入物插入后 50% ESS 降低（P=0.038；优势比：0.84）的决定因素。
悬雍垂过长（＞15mm）是降低腭植入物治疗打鼾疗效的重要解剖特征，应同时考虑行悬雍垂切除术等附加措施以获得更好的效果（等级 4）。
