Department of Otolaryngology, Second Affiliated Hospital, Xi'an Jiaotong University School of Medicine, Xi'an, People's Republic of China.
Respir Care. 2012 Dec;57(12):2104-10. doi: 10.4187/respcare.01695.
The aim of this retrospective long-term follow-up study was to assess 5-year outcomes after combined uvulopalatopharyngoplasty (UPPP) and midline glossectomy surgery for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS).
A total of 34 subjects with OSAHS with combinatory obstructions of posterior soft palate and posterior tongue area who underwent combined midline glossectomy and UPPP were successfully followed for 5 years to examine the therapeutic effect of treatment. All subjects were of Friedman stage II or III and had major stenoses at the base of the tongue. The apnea-hypopnea index (AHI), and mean lowest S(pO(2)) were measured preoperatively and postoperatively to assess therapeutic efficacy.
The mean preoperative AHI was 56.0 ± 8.4 episodes/h, while the mean lowest S(pO(2)) was 62.1 ± 10.6%. AHI and mean lowest S(pO(2)) were significantly increased and decreased, respectively, from preoperative levels at each follow-up point after surgery, up to 5 years (P < .05). The average widened pharyngeal space after surgery was 42 mm(2). At 6 months, surgery was classified as being curative in 27/34 (79.41%) of subjects, and markedly effective or effective in the remaining subjects. At 5 years, surgery was classified as being curative in 7/34 (20.59%) subjects, markedly effective or effective in 25/34 (73.53%) subjects, and not effective in 2/34 (5.88%) subjects. Five years after surgery the average body mass index for the subjects who were not cured was slightly higher than those who were cured, but the difference was not statistically significant (31.3 ± 3.7 kg/m(2) vs 29.7 ± 3.6 kg/m(2), P = .29). Subjects who were cured had lower supine AHI values than those who were not cured (2-year postoperative AHI 36.8 ± 9.2 episodes/h vs 43.8 ± 6.9 episodes/h, P = .03, 5-year post-operation AHI 32.1 ± 7.6 episodes/h vs 41.7 ± 8.2 episodes/h, P = .006).
These findings suggest that combined midline glossectomy and UPPP can be an effective treatment for subjects with Friedman stage II or III OSAHS and substantial stenosis around the base of the tongue.
本回顾性长期随访研究旨在评估悬雍垂腭咽成形术（UPPP）联合中线舌切除术治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的 5 年疗效。
共纳入 34 例因后软腭和后舌体联合阻塞而接受中线舌切除术联合 UPPP 的 OSAHS 患者，成功随访 5 年，以评估治疗效果。所有患者均为 Friedman II 或 III 期，舌根有明显狭窄。测量术前和术后呼吸暂停低通气指数（AHI）和最低 SpO2（mean lowest S(pO(2)))，以评估治疗效果。
术前平均 AHI 为 56.0 ± 8.4 次/小时，最低 SpO2（mean lowest S(pO(2)))为 62.1 ± 10.6%。术后各随访点 AHI 均显著升高，最低 SpO2（mean lowest S(pO(2)))均显著降低，至 5 年（P<.05）。术后咽腔平均扩张 42mm2。术后 6 个月，27/34（79.41%）例患者手术疗效为治愈，其余患者为显效或有效。5 年后，7/34（20.59%）例患者手术疗效为治愈，25/34（73.53%）例患者为显效或有效，2/34（5.88%）例患者为无效。5 年后，未治愈患者的平均 BMI 略高于治愈患者，但差异无统计学意义（31.3 ± 3.7 kg/m2 vs 29.7 ± 3.6 kg/m2，P =.29）。治愈患者的仰卧位 AHI 值低于未治愈患者（术后 2 年 AHI 36.8 ± 9.2 次/小时 vs 43.8 ± 6.9 次/小时，P =.03；术后 5 年 AHI 32.1 ± 7.6 次/小时 vs 41.7 ± 8.2 次/小时，P =.006）。
这些发现表明，对于 Friedman II 或 III 期 OSAHS 合并舌根明显狭窄的患者，中线舌切除术联合 UPPP 是一种有效的治疗方法。
