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舌骨悬吊术治疗因舌后坠引起的阻塞性睡眠呼吸暂停低通气综合征。

Treatment of obstructive sleep apnea hypopnea syndrome caused by glossoptosis with tongue-base suspension.

机构信息

Department of Otolaryngology-Head and Neck Surgery, General Hospital of Shenyang Military Area Command, No. 83, Wenhua Road, Shenhe District, Shenyang, 110840, China,

出版信息

Eur Arch Otorhinolaryngol. 2013 Nov;270(11):2915-20. doi: 10.1007/s00405-013-2536-7. Epub 2013 May 7.

DOI:10.1007/s00405-013-2536-7
PMID:23649508
Abstract

The objective of the study was to evaluate a surgical method to treat patients with obstructive sleep apnea hypopnea syndrome (OSAHS) caused by suspected glossoptosis. Seventy-eight patients with OSAHS caused by suspected glossoptosis were non-randomly divided into two groups. The 45 patients in the first group received uvulopalatopharyngoplasty (UPPP) and tongue-base suspension (Repose). The 33 patients in the second group received UPPP alone. Follow-up was conducted over 6 months, and polysomnography was used to determine the effects of treatment. Follow-up results revealed that the apnea-hypopnea index (AHI) and ESS scores of the patients from both groups were substantially decreased compared to the corresponding values before surgery. The lowest oxygen saturation (LaSo2) of both groups was improved, compared to the level before surgery. The degree of improvement in patients treated with UPPP + Repose was significantly greater than that seen in patients treated with UPPP alone. In the UPPP + Repose group, 17 patients were cured, 23 showed marked improvement, and 5 did not improve. In the UPPP alone group, 1 patient was cured, 16 showed marked improvement, and 16 did not improve. The marked improvement rates of the two groups were 88.9 and 51.5 %, respectively, a significant difference. Patients who show glossopharyngeal obstruction during sleep, and have normal glossopharyngeal airway morphology when awake, should be suspected to have glossoptosis. Repose surgery is an effective operation for the patients with OSAHS suspected glossoptosis.

摘要

本研究旨在评估一种治疗因悬雍垂过长、舌根后坠而导致阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的手术方法。78 例因悬雍垂过长、舌根后坠而疑似发生舌后坠的 OSAHS 患者被非随机分为两组。第一组 45 例患者接受悬雍垂腭咽成形术(UPPP)和舌根悬吊术(Repose),第二组 33 例患者仅接受 UPPP。术后随访 6 个月,采用多导睡眠图评估治疗效果。随访结果显示,两组患者的呼吸暂停低通气指数(AHI)和嗜睡量表(ESS)评分均较术前显著降低,最低血氧饱和度(LaSo2)较术前改善。UPPP+Repose 组的改善程度明显大于 UPPP 组。UPPP+Repose 组中,17 例患者治愈,23 例患者明显改善,5 例患者无改善;UPPP 组中,1 例患者治愈,16 例患者明显改善,16 例患者无改善。两组的显著改善率分别为 88.9%和 51.5%,差异有统计学意义。对于睡眠时出现咽舌后坠、清醒时咽舌后气道形态正常的患者,应考虑存在舌后坠。Repose 手术是治疗疑似舌后坠 OSAHS 患者的有效手术。

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A systematic review of tongue base suspension techniques as an isolated procedure or combined with uvulopalatopharyngoplasty in obstructive sleep apnea.一项关于舌根悬吊技术作为一种独立手术或与悬雍垂腭咽成形术联合用于阻塞性睡眠呼吸暂停的系统评价。
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