Cambi Jacopo, Chiri Zaira M, De Santis Sante, Franci Elisabetta, Frusoni Federica, Ciabatti Pier G, Boccuzzi Simone
Department of ENT, Ospedale della Misericordia, Grosseto, Italy.
Department of ENT, Ospedale San Donato, Arezzo, Italy.
Int J Med Robot. 2019 Dec;15(6):e2034. doi: 10.1002/rcs.2034. Epub 2019 Nov 25.
Many patients with obstructive sleep apnea syndrome (OSAS) have multiple obstructive sites simultaneously such as the oropharynx, hypopharynx, and larynx. Multilevel surgery is starting to be widely performed by ENT surgeons and accepted by patients.
Twenty consecutive patients with moderate or severe OSAS were treated with single-stage multilevel surgery. They underwent transoral robotic surgery for tongue base reduction or epiglottoplasty, expansion sphincter pharyngoplasty, and septoplasty.
The average length of hospitalization was 5.2 ± 0.9 days. No serious complications were observed. At the postoperative control with polysomnography, the apnea-hypopnea index (AHI) had decreased by at least 50% in 90% of patients; improvements were observed in all sleep parameters.
Single-stage multilevel surgery has proven to be effective in treating patients with moderate to severe OSAS, without experiencing persistent complaints. Despite multiple levels of obstruction being operated in a single stage, airway safety was maintained in all patients.
许多阻塞性睡眠呼吸暂停综合征（OSAS）患者同时存在多个阻塞部位，如口咽、下咽和喉部。耳鼻喉科医生开始广泛开展多平面手术，且该手术也为患者所接受。
连续20例中度或重度OSAS患者接受了单阶段多平面手术。他们接受了经口机器人手术以缩小舌根或进行会厌成形术、扩张括约肌咽成形术和鼻中隔成形术。
平均住院时间为5.2±0.9天。未观察到严重并发症。在术后多导睡眠图检查中，90%的患者呼吸暂停低通气指数（AHI）至少降低了50%；所有睡眠参数均有改善。
单阶段多平面手术已被证明对治疗中度至重度OSAS患者有效，且无持续不适。尽管在单阶段进行了多个平面的阻塞手术，但所有患者的气道安全性均得以维持。
