Ebrahim Mahmoud A K, AlSanea Osamah, Al-Terki Abdulmohsen E
Al-Sabah Hospital, Ministry of Health, Kuwait City, Kuwait.
Department of Surgery Health, Medical Clinic Dammam, Saudi Arabia.
Case Rep Otolaryngol. 2018 Mar 28;2018:4798024. doi: 10.1155/2018/4798024. eCollection 2018.
Obstructive sleep apnea (OSA) is a disease that is associated with high morbidity and mortality and can significantly impact the quality of life in a patient. OSA is strongly associated with obesity, and literature showed that weight loss will lead to improvement in OSA. The gold standard treatment for OSA is continuous positive airway pressure (CPAP). However, other methods of treatment are available. One of these methods is multilevel sleep surgery (MLS). Literature showed that bariatric surgery can also improve OSA. A common question is which surgical procedure of these two should be performed first. We present a 5-year follow-up of a patient who underwent simultaneously bariatric surgery and MLS. His apnea-hypopnea index (AHI) decreased from 53 episodes per hour to 5.2 per hour within the first 18 months, which was measured via a level 3 polysomnography. Five years after the surgery, a repeat level 3 polysomnography showed an AHI of 6.8 episodes per hour, and the patient is asymptomatic. The patient maintained his weight and did not use CPAP after the combined surgery during the five-year period.
阻塞性睡眠呼吸暂停（OSA）是一种发病率和死亡率都很高的疾病，会对患者的生活质量产生重大影响。OSA与肥胖密切相关，文献表明体重减轻会使OSA得到改善。OSA的金标准治疗方法是持续气道正压通气（CPAP）。然而，还有其他治疗方法。其中一种方法是多级睡眠手术（MLS）。文献表明，减肥手术也可以改善OSA。一个常见的问题是这两种手术程序应该先进行哪一种。我们对一名同时接受减肥手术和MLS的患者进行了5年随访。通过三级多导睡眠图测量，他的呼吸暂停低通气指数（AHI）在最初18个月内从每小时53次降至每小时5.2次。手术后5年，重复进行的三级多导睡眠图显示AHI为每小时6.8次，且患者无症状。在联合手术后的五年期间，该患者体重保持稳定，未使用CPAP。
