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扩张括约肌咽成形术治疗阻塞性睡眠呼吸暂停综合征的疗效

Efficiency of Expansion Sphincter Pharyngoplasty in the Treatment of Obstructive Sleep Apnea Syndrome.

作者信息

Güler İsmail, Kuzucu İhsan, Baklacı Deniz, Kum Rauf Oğuzhan, Kum Nurcan Yurtsever, Özcan Müge

机构信息

Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey.

出版信息

Turk Arch Otorhinolaryngol. 2018 Dec;56(4):206-209. doi: 10.5152/tao.2018.3665. Epub 2018 Dec 21.

Abstract

OBJECTIVE

Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of upper respiratory-tract obstruction during sleep and decrease in arterial oxygen saturation. Expansion sphincter pharyngoplasty (ESP) is a simple, safe, and effective method for the surgical treatment of OSAS. The aim of our study was to evaluate the efficacy of ESP with polysomnography (PSG) in OSAS patients.

METHODS

This study was conducted on patients referred to our center for the treatment of snoring, apnea, witnessed apnea, and daytime sleepiness during 2010-2018. Overall, 67 patients (16 females, 51 males) who had PSG test at postoperative three months and were considered suitable with history, physical examination, and surgery after PSG were included in the study. Patients were classified into three groups according to OSAS severity: mild, moderate, and severe. Patient age, sex, body mass index (BMI), pre- and postoperative period apnea-hypopnea index (AHI), Epworth sleepiness scores, and PSG data were recorded.

RESULTS

The mean BMI of all groups was 27.44±2.73. The postoperative AHI decreased from 18.26±2.23 to 8.01±0.97 (p<0.001). Surgical success rate was 67.2%; it was higher in females (p=0.047). The highest success rate was found in the mild OSAS group; however, this difference was not statistically significant when compared to the other groups (p=0.217). There were statistically significant improvement at postoperative Epworth sleepiness scores and minimum O saturations (p<0.001 and p=0.018, respectively).

CONCLUSION

ESP is an effective and successful surgery in selected patients with lateral pharyngeal and retropalatal narrowing.

摘要

目的

阻塞性睡眠呼吸暂停综合征(OSAS)的特征是睡眠期间上呼吸道反复阻塞以及动脉血氧饱和度下降。扩约肌咽成形术(ESP)是一种用于OSAS手术治疗的简单、安全且有效的方法。我们研究的目的是通过多导睡眠图(PSG)评估ESP治疗OSAS患者的疗效。

方法

本研究针对2010年至2018年期间转诊至我们中心治疗打鼾、呼吸暂停、目击性呼吸暂停和日间嗜睡的患者进行。总体而言,67例患者(16例女性,51例男性)在术后三个月进行了PSG测试,且根据病史、体格检查和PSG结果被认为适合手术,纳入本研究。根据OSAS严重程度将患者分为三组:轻度、中度和重度。记录患者的年龄、性别、体重指数(BMI)、术前和术后的呼吸暂停低通气指数(AHI)、爱泼华嗜睡量表评分以及PSG数据。

结果

所有组的平均BMI为27.44±2.73。术后AHI从18.26±2.23降至8.01±0.97(p<0.001)。手术成功率为67.2%;女性的成功率更高(p=0.047)。轻度OSAS组的成功率最高;然而,与其他组相比,这种差异无统计学意义(p=0.217)。术后爱泼华嗜睡量表评分和最低血氧饱和度有统计学显著改善(分别为p<0.001和p=0.018)。

结论

对于选定的有咽侧壁和腭后缩窄的患者,ESP是一种有效且成功的手术。

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