Göktas Önder, Solmaz Mustafa, Göktas Gökhan, Olze Heidi
Charité University of Berlin, CCM, Department of Otorhinolaryngology, Berlin, Germany.
PLoS One. 2014 Jun 30;9(6):e100211. doi: 10.1371/journal.pone.0100211. eCollection 2014.
Obstructive sleep apnea syndrome (OSAS) is a serious disease. The etiology of and optimum therapy options for this disorder have been much discussed and have been the subject of many publications. One much discussed therapy option is laser-assisted uvulopalatoplasty (LAUP). Despite conflicting opinions and guidelines which recommend that it should not be used, it remains in use. Patients who had previously undergone this procedure were invited for follow-up appointments, at which they were asked to complete a questionnaire, underwent an ENT examination and underwent sleep laboratory analysis using a portable sleep lab device. The average time since LAUP treatment was 11 years. The cohort comprised 25 patients. The average preoperative apnea-hypopnea-index (AHI) score was 25.25/h; the average postoperative AHI score 23.62/h. Closer examination of our data enabled us to identify 10 responders (40%) and 15 non-responders (60%). 12% (3/25) of non-responders experienced either no reduction in their AHI score or an increase compared to their preoperative AHI score of less than 5/h. In the remaining 48% (12/25), AHI increased by more than 5/h compared to the preoperative figure. Our questionnaire showed that 40% (10/25) of patients suffered from dry mouth and 20% (5/25) from foreign body sensation. The data led us to conclude that laser-assisted uvulopalatoplasty can indeed result in a reduction in AHI score comparable to other mucosal resection methods. Also in common with these methods, the efficacy of the therapy reduces with time and the procedure carries a high risk of bringing about an increase in the patient's AHI score.
阻塞性睡眠呼吸暂停综合征（OSAS）是一种严重疾病。关于该疾病的病因及最佳治疗方案已被广泛讨论，并有诸多相关出版物。其中一个备受讨论的治疗方案是激光辅助悬雍垂腭咽成形术（LAUP）。尽管存在相互矛盾的观点以及不建议使用该方法的指南，但它仍在使用。曾接受过此手术的患者被邀请进行随访预约，期间要求他们填写一份问卷，接受耳鼻喉科检查，并使用便携式睡眠实验室设备进行睡眠实验室分析。自LAUP治疗后的平均时间为11年。该队列包括25名患者。术前平均呼吸暂停低通气指数（AHI）评分为25.25次/小时；术后平均AHI评分为23.62次/小时。对我们的数据进行仔细分析后，我们确定了10名有反应者（40%）和15名无反应者（60%）。12%（3/25）的无反应者与术前AHI评分相比，AHI评分未降低或升高幅度小于5次/小时。在其余48%（12/25）的患者中，AHI较术前数值升高超过5次/小时。我们的问卷显示，40%（10/25）的患者有口干症状，20%（5/25）的患者有异物感。这些数据使我们得出结论，激光辅助悬雍垂腭咽成形术确实可以使AHI评分降低，效果与其他黏膜切除术方法相当。同样与这些方法一样，该治疗的疗效会随时间降低，且该手术有很高风险导致患者AHI评分升高。
