Division of Otorhinolaryngology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil.
Sleep Med. 2013 Dec;14(12):1266-71. doi: 10.1016/j.sleep.2013.08.777. Epub 2013 Aug 23.
Uvulopalatopharyngoplasty (UPPP) has been described as an option for treating obstructive sleep apnea syndrome (OSAS), with variable success rates. The main purpose of our study was to correlate UPPP success to craniofacial bony structure and orofacial muscles function.
Clinical variables, including body mass index (BMI), age, and preoperative apnea-hypopnea index (AHI); cephalometric measurements of the craniofacial region and hyoid bone position; and muscle function variables including clinical protocol and tongue strength measures were evaluated in 54 patients who underwent UPPP in the last 7years. The measurements were related to the success or failure of UPPP based on the results of preoperative and postoperative polysomnography (PSG).
The variables BMI, preoperative AHI, and cephalometric measurements showed no influence on surgical success. The clinical muscle protocol also was similar between groups. However, the muscle strength of the anterior portion of the tongue was significantly greater in the group that showed surgical success compared to those with surgical failure.
OSAS is a multifactorial disease and diagnostic symptom assessments should be individualized. In addition, special attention should be given to functional muscle alterations of the airways, as they might influence the evolution of the disease.
悬雍垂腭咽成形术（UPPP）已被描述为治疗阻塞性睡眠呼吸暂停综合征（OSAS）的一种选择，其成功率不一。我们研究的主要目的是将 UPPP 的成功与颅面骨结构和口咽肌肉功能相关联。
在过去 7 年中，我们对 54 例行 UPPP 的患者进行了临床变量（包括体重指数[BMI]、年龄和术前呼吸暂停低通气指数[AHI]）、颅面区域和舌骨位置的头影测量以及包括临床方案和舌肌力量测量在内的肌肉功能变量的评估。这些测量结果与术前和术后多导睡眠图（PSG）的结果相关联，以确定 UPPP 的成功或失败。
BMI、术前 AHI 和头影测量等变量对手术成功率没有影响。两组间的临床肌肉方案也相似。然而，与手术失败组相比，手术成功组的舌前部分肌肉力量明显更大。
OSAS 是一种多因素疾病，诊断症状评估应个体化。此外，应特别注意气道功能肌肉的改变，因为它们可能会影响疾病的演变。
