Department of Otolaryngology Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan 48202, USA.
Laryngoscope. 2011 Jul;121(7):1590-3. doi: 10.1002/lary.21823. Epub 2011 Jun 10.
OBJECTIVES/HYPOTHESIS: To evaluate the effect of surgical intervention for obstructive sleep apnea (OSA) on patients' level of excessive daytime sleepiness as determined by the Epworth Sleepiness Scale (ESS). The ESS questionnaire is a validated measure of subjective daytime sleepiness. There have been several studies that have shown that continuous positive airway pressure (CPAP) improves excessive daytime sleepiness in OSA patients as measured by the ESS.
Retrospective case series.
This is a study of patients who had uvulopalatopharyngoplasty (UPPP); UPPP and tonsillectomy; or UPPP, tonsillectomy, and radiofrequency ablation of the base of the tongue for OSA between January 2007 and December 2009. Forty patients were identified who met the criteria of having had an ESS evaluation and polysomnography prior to surgery for OSA.
Across all of the patients there was a mean reduction of their ESS by 5.6 ± 4.1; t = 8.82, P < .001. Only three of the patients did not improve in their ESS scores after surgical treatment for OSA.
Surgical intervention for OSA significantly improves sleepiness in OSA patients as measured by the ESS. Two meta-analyses of multiple, randomized, controlled studies showed patients with mild to moderate OSA treated with CPAP demonstrated an improvement in the ESS score of 1.2 points (95% confidence interval, 0.05-1.9, P = .001) and 2.94 points for patients with mild to severe OSA treated with CPAP. The results of this study show an improvement in ESS after surgery that is substantially higher than previously reported with CPAP for all categories of OSA.
目的/假设：评估手术干预阻塞性睡眠呼吸暂停（OSA）对患者日间嗜睡程度的影响，采用 Epworth 睡眠量表（ESS）进行评估。ESS 问卷是评估主观日间嗜睡的有效工具。已有多项研究表明，持续气道正压通气（CPAP）可改善 OSA 患者的日间嗜睡，ESS 评分可对此进行测量。
回顾性病例系列研究。
这是一项关于在 2007 年 1 月至 2009 年 12 月期间接受悬雍垂腭咽成形术（UPPP）、UPPP 联合扁桃体切除术、UPPP、扁桃体切除术联合舌根射频消融术治疗 OSA 的患者的研究。符合术前 OSA 行 ESS 评估和多导睡眠图检查的标准的 40 名患者被确定为研究对象。
所有患者的 ESS 评分平均降低 5.6±4.1；t=8.82，P<.001。只有 3 名患者在 OSA 的手术治疗后 ESS 评分没有改善。
OSA 的手术干预可显著改善 ESS 评估的 OSA 患者的嗜睡程度。两项包含多项随机对照研究的荟萃分析显示，中重度 OSA 患者接受 CPAP 治疗后 ESS 评分改善 1.2 分（95%置信区间，0.05-1.9，P=.001），轻度至重度 OSA 患者接受 CPAP 治疗后 ESS 评分改善 2.94 分。本研究结果显示，手术后 ESS 评分的改善显著高于此前报道的 CPAP 治疗所有 OSA 类别的改善。
