Turhan Murat, Bostanci Asli, Akdag Mehmet
Department of Otolaryngology-Head and Neck Surgery, Akdeniz University Hospital, Antalya, Turkey.
, Uncali mah. 30ncu cd. Doga Park Evleri. B Blok No: 2/14, 07070, Konyaalti, Antalya, Turkey.
Eur Arch Otorhinolaryngol. 2015 Apr;272(4):995-1000. doi: 10.1007/s00405-014-3034-2. Epub 2014 Apr 11.
The aim of this study was to evaluate the effects of modified tongue base suspension (mTBS) procedure on continuous positive airway pressure (CPAP) levels in patients with severe obstructive sleep apnea (OSA). From November 2011 to December 2012, a total of 31 patients with severe OSA who underwent mTBS were included into this prospective case series with planned data collection. Prior to surgery, all the patients were subjected to a polysomnography (PSG) and CPAP titration on two separate nights. Following the surgery, patients were subjected to a control PSG and CPAP titration at the sixth month of follow-up period. The preoperative and postoperative mean apnea hypopnea index (AHI), CPAP titration values, AHI during CPAP use and amount of sleeping time with CPAP were compared. Median age was 48 years (range 31-66), and most patients were male (87.0 %). Postoperative mean AHI (44.73 ± 17.05 vs. 19.96 ± 19.52), optimal CPAP value (12.64 ± 1.60 vs. 8.00 ± 1.77) and AHI during CPAP use (3.79 ± 1.78 vs. 2.25 ± 1.81) were decreased, and the amount of sleeping time with CPAP (5.29 ± 0.84 vs. 6.52 ± 0.89) was increased significantly (p < 0.001 for all parameters). The surgery was considered to be successful when 50 % reduction in the mean AHI and/or the decrease of AHI below 20/h were obtained. A total of 24 patients (77.4 %) met the surgical success criteria. The mTBS is a safe and feasible procedure with favorable effects on CPAP levels in patients with severe OSA.
本研究的目的是评估改良舌根悬吊术(mTBS)对重度阻塞性睡眠呼吸暂停(OSA)患者持续气道正压通气(CPAP)水平的影响。2011年11月至2012年12月,共有31例行mTBS的重度OSA患者纳入本前瞻性病例系列并计划收集数据。手术前,所有患者均在两个不同的夜晚接受多导睡眠图(PSG)检查和CPAP滴定。手术后,患者在随访期的第六个月接受对照PSG检查和CPAP滴定。比较术前和术后的平均呼吸暂停低通气指数(AHI)、CPAP滴定值、使用CPAP期间的AHI以及使用CPAP的睡眠时间。中位年龄为48岁(范围31 - 66岁),大多数患者为男性(87.0%)。术后平均AHI(44.73±17.05对19.96±19.52)、最佳CPAP值(12.64±1.60对8.00±1.77)以及使用CPAP期间的AHI(3.79±1.78对2.25±1.81)均降低,而使用CPAP的睡眠时间(5.29±0.84对6.52±0.89)显著增加(所有参数p<0.001)。当平均AHI降低50%和/或AHI降至20次/小时以下时,手术被认为成功。共有24例患者(77.4%)符合手术成功标准。mTBS是一种安全可行的手术,对重度OSA患者的CPAP水平有良好影响。