Liu Stanley Yung, Riley Robert Wayne
Assistant Professor and Co-Director of Stanford Sleep Surgery Fellowship, Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA.
Clinical Professor of Stanford Sleep Surgery, Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA.
J Oral Maxillofac Surg. 2017 Jul;75(7):1514-1518. doi: 10.1016/j.joms.2017.02.008. Epub 2017 Feb 20.
In 1993, a surgical protocol for dynamic upper airway reconstruction in patients with obstructive sleep apnea (OSA) was published, and it became commonly known as the Stanford phase 1 and 2 sleep surgery protocol. It served as a platform on which research and clinical studies have continued to perfect the surgical care of patients with OSA. However, relapse is inevitable in a chronic condition such as OSA, and a subset of previously cured surgical patients return with complaints of excessive daytime sleepiness. This report describes a patient who was successfully treated with phase 1 and 2 operations more than a decade previously. He returned at 65 years of age with relapse of moderate OSA, and after workup with polysomnography and drug-induced sleep endoscopy, he underwent upper airway stimulation of the hypoglossal nerve that resulted in a cure of OSA. This case shows why upper airway stimulation is an appropriate option for patients with OSA relapse, after previously successful maxillomandibular advancement.
1993年，一篇关于阻塞性睡眠呼吸暂停（OSA）患者动态上气道重建的外科手术方案发表了，它后来广为人知，被称为斯坦福一期和二期睡眠手术方案。它成为了一个平台，在此基础上，研究和临床研究不断完善对OSA患者的手术治疗。然而，在OSA这种慢性病中复发是不可避免的，一部分曾接受手术治愈的患者会再次出现白天过度嗜睡的症状。本报告描述了一名十多年前成功接受一期和二期手术治疗的患者。他65岁时因中度OSA复发前来就诊，在接受多导睡眠图检查和药物诱导睡眠内镜检查后，他接受了舌下神经上气道刺激术，最终治愈了OSA。该病例表明了为什么对于先前成功进行上颌下颌前移术后OSA复发的患者，上气道刺激术是一种合适的选择。
