Mase Caitlin A, Chen Maida L, Horn David L, Parikh Sanjay R
Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA, United States.
Division of Pediatric Pulmonary and Sleep Medicine, Seattle Children's Hospital, Seattle, WA, United States.
Int J Pediatr Otorhinolaryngol. 2015 Apr;79(4):511-5. doi: 10.1016/j.ijporl.2015.01.018. Epub 2015 Jan 23.
To evaluate the polysomnographic outcomes of supraglottoplasty (SGP) performed for sleep endoscopy diagnosed sleep dependent laryngomalacia as treatment for obstructive sleep apnea syndrome (OSAS).
Nine subjects aged 6-55 months underwent supraglottoplasty for sleep dependent laryngomalacia. All subjects underwent both pre- and post-procedural polysomnograms.
Supraglottoplasty for sleep dependent laryngomalacia resulted in improvement of OSAS as measured by collective improvements in 8 different primary polysomnogram parameters: apnea-hypopnea index (AHI), minimum (nadir) and mean oxygen saturation, mean and maximum carbon dioxide, total sleep time, sleep efficiency, arousal index, as well as improvement in weight for length percentiles. Subjects had a significant 80% decrease in percentage change in AHI (p<0.005), with decrease in mean AHI from 23.4 to 4.8 following supraglottoplasty. Seven of 9 subjects demonstrated improvement in nadir saturations, 6 of 9 subjects had improvement in sleep efficiency, and 7 of 8 subjects under 4 years of age had improvement in weight for length percentile.
Supraglottoplasty for sleep dependent laryngomalacia is an effective treatment of OSAS, and can be readily diagnosed using sleep endoscopy. Further investigation is warranted to increase awareness and outcomes related to sleep dependent laryngomalacia.
评估针对睡眠内镜诊断为睡眠相关性喉软化症而施行的声门上成形术（SGP）治疗阻塞性睡眠呼吸暂停综合征（OSAS）的多导睡眠图结果。
9名年龄在6至55个月的受试者接受了针对睡眠相关性喉软化症的声门上成形术。所有受试者在手术前后均进行了多导睡眠图检查。
针对睡眠相关性喉软化症的声门上成形术使OSAS得到改善，这通过8种不同的主要多导睡眠图参数的综合改善得以衡量：呼吸暂停低通气指数（AHI）、最低（最低点）和平均血氧饱和度、平均和最高二氧化碳水平、总睡眠时间、睡眠效率、觉醒指数，以及身长体重百分比的改善。受试者的AHI百分比变化显著降低了80%（p<0.005），声门上成形术后平均AHI从23.4降至4.8。9名受试者中有7名最低点饱和度有所改善，9名受试者中有6名睡眠效率有所提高，8名4岁以下受试者中有7名身长体重百分比有所改善。
针对睡眠相关性喉软化症的声门上成形术是治疗OSAS的有效方法，并且可以通过睡眠内镜轻易诊断。有必要进行进一步研究以提高对睡眠相关性喉软化症的认识和改善其治疗效果。
