腭裂手术的长期并发症：217 例患者的多中心研究。
Long-term Complications of Palate Surgery: A Multicenter Study of 217 Patients.
机构信息
Asia Sleep Centre, Paragon, Singapore.
G.B. Morgagni-L. Pierantoni Hospital, University of Ferrara and Bologna, Forli, Italy.
出版信息
Laryngoscope. 2020 Sep;130(9):2281-2284. doi: 10.1002/lary.28432. Epub 2019 Nov 25.
OBJECTIVES/HYPOTHESIS: To investigate long-term complications of newer reconstructive palate surgery techniques.
STUDY DESIGN
Retrospective case-series analysis.
METHODS
Retrospective six-country clinical study of OSA patients who had nose and palate surgery.
RESULTS
There were 217 patients, mean age = 43.9 ± 12.5 years, mean body mass index = 25.9 ± 4.7, mean preoperative apnea-hypopnea index [AHI] = 30.5 ± 19.1, follow-up 41.3 months. A total of 217 palatal procedures were performed, including 50 expansion sphincter pharyngoplasties (ESP), 34 functional expansion pharyngoplasties (FEP), 40 barbed reposition pharyngoplasties (BRP), 64 modified uvulopalatopharyngoplasties (mUPPP), 11 uvulopalatal flap procedures (UPF), nine suspension pharyngoplasties (SP), eight relocation pharyngoplasties (RP), and one z-pharyngoplasty (ZPP). Complications included were constant and/or felt twice per week; dry throat (7.8%), throat lump feeling (11.5%), throat phlegm (10.1%), throat scar feeling (3.7%), and difficulty swallowing (0.5%). Of the 17 patients who had a dry throat complaint, two were constant (one SP, one RP), 15 were occasional (10 mUPPP, three SP, two BRP). Of the 25 patients with the throat lump feeling, four were constant (three RP, one ZPP), 21 were occasional (10 mUPPP, five SP, five UPF, one BRP). Of the 22 patients with the throat phlegm feeling, four were constant (two SP, two RP), 18 were occasional (10 mUPPP, four BRP, two FEP, two SP). Of the eight patients with throat scar feeling, eight were occasional (four SP, two mUPPP, one FEP, one RP), none were constant. One patient had difficulty swallowing (RP procedure). There was no velopharyngeal incompetence, taste disturbance, nor voice change. Highest symptom complaints were mUPPP, SP, and RP, whereas the lowest symptom complaint was ESP.
CONCLUSIONS
Newer palatal techniques have shown to have less long-term complications compared to the older ablative techniques.
LEVEL OF EVIDENCE
4 Laryngoscope, 130:2281-2284, 2020.
目的/假设：研究新型重建腭手术技术的长期并发症。
研究设计
回顾性多中心病例系列分析。
方法
对行鼻腭手术的 OSA 患者进行回顾性六国临床研究。
结果
共有 217 例患者，平均年龄=43.9±12.5 岁，平均体重指数=25.9±4.7，平均术前呼吸暂停低通气指数[AHI]=30.5±19.1，随访 41.3 个月。共行 217 例腭手术，其中 50 例扩张环咽肌咽成型术（ESP）、34 例功能性扩张咽成型术（FEP）、40 例带刺再定位咽成型术（BRP）、64 例改良悬雍垂腭咽成形术（mUPPP）、11 例悬雍垂腭咽成形术（UPF）、9 例悬雍垂咽成型术（SP）、8 例复位咽成型术（RP）和 1 例 Z 成形术（ZPP）。并发症包括每周出现 2 次或以上的持续性和/或感觉；咽喉干燥（7.8%）、咽喉有肿块感（11.5%）、咽喉有痰感（10.1%）、咽喉有疤痕感（3.7%）和吞咽困难（0.5%）。在 17 例有咽喉干燥感的患者中，2 例为持续性（1 例 SP，1 例 RP），15 例为偶发性（10 例 mUPPP，3 例 SP，2 例 BRP）。在 25 例有咽喉肿块感的患者中，4 例为持续性（3 例 RP，1 例 ZPP），21 例为偶发性（10 例 mUPPP，5 例 SP，5 例 UPF，1 例 BRP）。在 22 例有咽喉有痰感的患者中，4 例为持续性（2 例 SP，2 例 RP），18 例为偶发性（10 例 mUPPP，4 例 BRP，2 例 FEP，2 例 SP）。在 8 例有咽喉疤痕感的患者中，8 例为偶发性（4 例 SP，2 例 mUPPP，1 例 FEP，1 例 RP），均无持续性。1 例患者有吞咽困难（RP 手术）。无软腭咽闭合不全、味觉障碍或声音改变。症状最严重的是 mUPPP、SP 和 RP，而症状最轻的是 ESP。
结论
与传统消融技术相比，新型腭部手术技术具有更少的长期并发症。
证据水平
4 级喉镜 130:2281-2284，2020 年。
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