Dizdar Denizhan, Civelek Şenol, Çaliş Zeynep Asli Batur, Dizdar Senem Kurt, Coşkun Berna Uslu, Vural Alperen
*Department of Otorhinolaryngology, Gaziosmanpaşa Taksim Training and Research Hospital †Department of Otorhinolaryngology, Fatih University ‡Department of Otorhinolaryngology, Hamidiye Şişli Etfal Training and Research Hospital §Department of Otorhinolaryngology, Hamidiye Şişli Etfal Training and Research Hospital, Istanbul ||Department of Otorhinolaryngology, Erciyes University, Kayseri, Turkey.
J Craniofac Surg. 2015 Oct;26(7):e647-51. doi: 10.1097/SCS.0000000000001979.
Snoring is caused by the vibration of structures of the oral cavity, such as the soft palate, uvula, tonsils, base of the tongue, epiglottis, and lateral pharyngeal walls. When these structures collapse and obstruct the airway, apnea occurs. Obstructive sleep apnea syndrome (OSAS) is characterized by repeated periods of upper airway obstruction, a decrease in arterial oxygen saturation, and interrupted sleep. The prevalence of OSAS is 1% to 5% in men and 1.2% to 2.5% in women. Crucial factors in deciding the surgical approach include a detailed ear-nose-throat examination, Muller maneuver, sleep endoscopy, and apnea hypopnea index scores. Accepted treatments include continuous positive airway pressure (CPAP), surgeries of the base of the tongue and/or palate, and multi-level surgeries. It, however, is important to continue to evaluate the efficacies of such procedures. The authors evaluated the outcomes of 23 patients who underwent surgery for OSAS, using preoperative and postoperative polysomnography (PSG) and the Epworth sleepiness scale (ESS). The results were compared before and after surgery. In all, 14 patients had lateral pharyngoplasty and 9 had uvulopalatopharyngoplasty (UPPP). The PSG and Epworth scale values were significantly lower in both groups, postoperatively. Patients indicated that their quality of life had improved. In conclusion, the surgeries were successful. In line with the literature, our results indicate that lateral pharyngoplasty and UPPP can be used in appropriate patients. Longer-term studies on more patients will provide more detailed information in the future.
打鼾是由口腔结构振动引起的,如软腭、悬雍垂、扁桃体、舌根、会厌和咽侧壁。当这些结构塌陷并阻塞气道时,就会发生呼吸暂停。阻塞性睡眠呼吸暂停综合征(OSAS)的特征是上呼吸道反复阻塞、动脉血氧饱和度下降和睡眠中断。OSAS在男性中的患病率为1%至5%,在女性中的患病率为1.2%至2.5%。决定手术方法的关键因素包括详细的耳鼻喉检查、米勒动作、睡眠内镜检查和呼吸暂停低通气指数评分。公认的治疗方法包括持续气道正压通气(CPAP)、舌根和/或腭部手术以及多级手术。然而,继续评估这些手术的疗效很重要。作者使用术前和术后多导睡眠图(PSG)和爱泼华嗜睡量表(ESS)评估了23例接受OSAS手术患者的结果。对手术前后的结果进行了比较。总共有14例患者接受了咽侧成形术,9例接受了悬雍垂腭咽成形术(UPPP)。两组术后的PSG和爱泼华量表值均显著降低。患者表示他们的生活质量有所改善。总之,手术是成功的。与文献一致,我们的结果表明咽侧成形术和UPPP可用于合适的患者。未来对更多患者进行的长期研究将提供更详细的信息。