Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul, South Korea.
Laryngoscope. 2013 Jan;123(1):269-76. doi: 10.1002/lary.23470. Epub 2012 Aug 2.
OBJECTIVES/HYPOTHESIS: The Pillar implant is one of the surgical options for snoring and obstructive sleep apnea (OSA). It is designed to be inserted into the soft palate to reduce vibration and collapsibility. The efficacy of the Pillar implant has been evaluated in various studies. However, only one study conducted a meta-analysis of the findings, and was based on only three studies. We tried to get a more definite conclusion on the efficacy of the Pillar implant.
Meta-analysis.
Efficacies were analyzed separately, one for snoring and the other for mild-to-moderate OSA. We searched MEDLINE, LILACS, SCOPUS, and the Cochrane Library. The key words "snoring AND implants" were used for snoring, and "apnea AND implants" for OSA. Seven studies for snoring and seven studies for mild-to-moderate OSA were finally included for meta-analysis. For snoring patients, a visual analogue scale that is scored by the bed partner was used to evaluate the loudness of the snoring sound.
The Pillar implant reduced snoring sound significantly (standardized mean difference [SMD], -0.591; 95% confidence interval [CI], -0.753 to -0.429, P < .001). For mild-to-moderate OSA patients, the Pillar implant significantly reduced the Epworth Sleepiness Scale (SMD, -0.481; 95% CI, -0.606 to -0.358, P < .001), and apnea-hypopnea index (SMD, -0.378; 95% CI, -0.619 to -0.138, P = .002). Mean extrusion rate was 9.3% (95% CI, 7.0 to 12.2%).
The present results indicate that the Pillar implant has a moderate effect on snoring and mild-to-moderate OSA. However, we need more studies with high level of evidence to arrive at a definite conclusion.
目的/假设：支柱植入物是治疗打鼾和阻塞性睡眠呼吸暂停（OSA）的手术选择之一。它被设计为插入软腭以减少振动和塌陷。支柱植入物的疗效已在各种研究中进行了评估。然而，只有一项研究对这些研究结果进行了荟萃分析，并且仅基于三项研究。我们试图对支柱植入物的疗效得出更明确的结论。
荟萃分析。
分别分析疗效，一种用于治疗打鼾，另一种用于治疗轻度至中度 OSA。我们搜索了 MEDLINE、LILACS、SCOPUS 和 Cochrane 图书馆。关键词“打鼾和植入物”用于打鼾，“呼吸暂停和植入物”用于 OSA。最终纳入了 7 项用于治疗打鼾和 7 项用于治疗轻度至中度 OSA 的研究进行荟萃分析。对于打鼾患者，使用配偶评分的视觉模拟量表来评估打鼾声音的响度。
支柱植入物可显著降低打鼾声音（标准化均数差 [SMD]，-0.591；95%置信区间 [CI]，-0.753 至 -0.429，P<.001）。对于轻度至中度 OSA 患者，支柱植入物可显著降低嗜睡量表评分（SMD，-0.481；95%CI，-0.606 至 -0.358，P<.001）和呼吸暂停低通气指数（SMD，-0.378；95%CI，-0.619 至 -0.138，P=.002）。平均挤出率为 9.3%（95%CI，7.0 至 12.2%）。
目前的结果表明，支柱植入物对打鼾和轻度至中度 OSA 有中度疗效。然而，我们需要更多具有高证据水平的研究来得出明确的结论。
