Puccia Ryan, Woodson Beverly Tucker
Department of Otolaryngology and Human Communication, Medical College Wisconsin, Milwaukee, WI 53226, USA.
Division of Sleep Medicine and Sleep Surgery, Department of Otolaryngology and Human Communication, Medical College Wisconsin, 98701 Watertown Plank Road, Milwaukee, WI 53226, USA.
Otolaryngol Clin North Am. 2020 Jun;53(3):421-429. doi: 10.1016/j.otc.2020.02.005. Epub 2020 Apr 23.
Successful palatopharyngoplasty is critical for successful sleep apnea surgery. Traditional uvulopalatopharyngoplasty was primarily excisional, whereas newer techniques, such as expansion sphincterpharyngoplasty, are more reconstructive. Studies of flow dynamics even demonstrate that the effectiveness of maxillofacial surgery is significantly mediated through stiffening and enlargement of the lateral retropalatal and pharyngeal airway. The current modified technique of uvulopalatopharyngoplasty/expansion sphincteroplasty aims to maximize relocation and tension on the palatopharyngeus muscle, opening the retropalatal airway and the palatal genu, and minimizing tension on the final mucosal closure.
成功的腭咽成形术对于成功的睡眠呼吸暂停手术至关重要。传统的悬雍垂腭咽成形术主要是切除性的,而较新的技术,如扩张括约肌咽成形术,则更侧重于重建。血流动力学研究甚至表明,颌面外科手术的有效性通过腭后外侧和咽气道的硬化和扩大而显著介导。目前改良的悬雍垂腭咽成形术/扩张括约肌成形术技术旨在最大限度地重新定位腭咽肌并使其产生张力,打开腭后气道和腭膝,同时最小化最终黏膜闭合处的张力。