Baradaranfar Mohammad Hossein, Edalatkhah Mohsen, Dadgarnia Mohammad Hossein, Atighechi Saeid, Behniafard Nasim, Mirvakili Abbas, Halvani Abolhassan, Baradaranfar Amin, Emami Meybodi Touhid
Rhinology Research Center, Department of Otolaryngology Head and Neck Surgery, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Avicenna Blvd, Safaeeh, Yazd, Iran.
Department of Internal Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Indian J Otolaryngol Head Neck Surg. 2015 Mar;67(Suppl 1):29-33. doi: 10.1007/s12070-014-0735-1. Epub 2014 Jun 17.
In the current study, we evaluated the effectiveness of uvulopalatopharyngoplasty (UPPP) in treatment of patients with obstructive sleep apnea (OSA) syndrome. All patients were previously received medical treatment but their symptoms did not resolve. A prospective study was conducted in Shahid Sadoughi Hospital in Yazd, Iran. Several sleep indices were evaluated using polysomnography (PSG) in all patients before performing UPPP and tonsillectomy. All patients were visited 6 months after surgery and PSG was repeated to assess the efficacy of surgical intervention. A total of 48 patients were enrolled and underwent UPPP and tonsillectomy. Six months after surgery, significant improvements were observed in all indices of sleep (apnea-hypopnea index, respiratory distress index, arterial oxygen saturation, and snoring index). The score of daytime sleepiness (assessed by Epworth score) was also improved. According to the result of this study, using UPPP surgery in patients with OSA can cause symptoms improvement in 64 % of cases. It seems that Muller's maneuver test has assisted in briefly increasing success rate after surgery, though to prove this claim; other studies should be designed and performed in a randomized clinical trial.
在本研究中,我们评估了悬雍垂腭咽成形术(UPPP)治疗阻塞性睡眠呼吸暂停(OSA)综合征患者的有效性。所有患者此前均接受过药物治疗,但症状未得到缓解。在伊朗亚兹德的沙希德·萨杜基医院进行了一项前瞻性研究。在所有患者进行UPPP和扁桃体切除术前,使用多导睡眠图(PSG)评估了多个睡眠指标。所有患者在术后6个月接受随访,并再次进行PSG以评估手术干预的疗效。共有48例患者纳入研究并接受了UPPP和扁桃体切除术。术后6个月,所有睡眠指标(呼吸暂停低通气指数、呼吸窘迫指数、动脉血氧饱和度和打鼾指数)均有显著改善。日间嗜睡评分(通过爱泼华嗜睡量表评估)也有所改善。根据本研究结果,对OSA患者使用UPPP手术可使64%的病例症状得到改善。尽管为证实这一说法,还应设计并开展其他随机临床试验,但似乎米勒动作试验有助于在术后短期内提高成功率。