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我们应该停止进行悬雍垂腭咽成形术吗?

Should we stop performing uvulopalatopharyngoplasty?

作者信息

Mantovani Mario, Rinaldi Vittorio, Salamanca Fabrizio, Torretta Sara, Carioli Daniela, Gaffuri Michele, Pignataro Lorenzo

机构信息

Department of Otolaryngology, Department of Clinical Sciences and Community Health, University of Milan, Fondazione I.R.C.C.S. Cà Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy.

Department of Otolaryngology, S. Pio X Hospital, Milan, Italy.

出版信息

Indian J Otolaryngol Head Neck Surg. 2015 Mar;67(Suppl 1):161-2. doi: 10.1007/s12070-014-0800-9. Epub 2014 Nov 20.

Abstract

Uvulopalatopharyngoplasty (UPPP) is still one of the most frequently performed procedures for snoring and obstructive sleep apnea syndrome (OSAS) in adults, with unsatisfactory results. In the era of the mini-invasive/conservative surgery, considering the increasing attention to the disregulation of the peripheral neuromuscular control of the upper airway contributing to pharyngeal collapse in OSAS, with the development of sophisticated treatments such as the neural stimulation of the upper-airway, which role should be reserved to a muscular resective procedure such as UPPP? Being aware of the uncertain results and the high postoperative morbidity of UPPP, we believe that we should re-evaluate the role of these procedures involving the resection of palatal/pharyngeal muscles and uvula.

摘要

悬雍垂腭咽成形术(UPPP)仍然是成人打鼾和阻塞性睡眠呼吸暂停综合征(OSAS)最常施行的手术之一,但其效果并不理想。在微创/保守手术时代,鉴于人们越来越关注上气道周围神经肌肉控制失调导致OSAS患者咽部塌陷的问题,随着诸如上气道神经刺激等先进治疗方法的发展,像UPPP这样的肌肉切除手术应保留何种作用?鉴于UPPP结果不确定且术后发病率高,我们认为应该重新评估这些涉及切除腭部/咽部肌肉及悬雍垂的手术的作用。

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