Thomas Jefferson University, Philadelphia, PA, USA.
Kantonsspital Baselland, Liestal, Switzerland.
Ann Otol Rhinol Laryngol. 2021 Apr;130(4):370-376. doi: 10.1177/0003489420953178. Epub 2020 Aug 29.
To compare patients with moderate-severe obstructive sleep apnea (OSA) undergoing traditional single and multilevel sleep surgery to those undergoing upper airway stimulation (UAS).
Case control study comparing retrospective cohort of patients undergoing traditional sleep surgery to patients undergoing UAS enrolled in the ADHERE registry.
8 multinational academic medical centers.
233 patients undergoing prior single or multilevel traditional sleep surgery and meeting study inclusion criteria were compared to 465 patients from the ADHERE registry who underwent UAS. We compared preoperative and postoperative demographic, quality of life, and polysomnographic data. We also evaluated treatment response rates.
The pre and postoperative apnea hypopnea index (AHI) was 33.5 and 15 in the traditional sleep surgery group and 32 and 10 in the UAS group. The postoperative AHI in the UAS group was significantly lower. The pre and postoperative Epworth sleepiness scores (ESS) were 12 and 6 in both the traditional sleep surgery and UAS groups. Subgroup analysis evaluated those patients undergoing single level palate and multilevel palate and tongue base traditional sleep surgeries. The UAS group had a significantly lower postoperive AHI than both traditional sleep surgery subgroups. The UAS group had a higher percentage of patients reaching surgical success, defined as a postoperative AHI <20 with a 50% reduction from preoperative severity.
UAS offers significantly better control of AHI severity than traditional sleep surgery. Quality life improvements were similar between groups.
比较接受传统单水平和多水平睡眠手术治疗的中重度阻塞性睡眠呼吸暂停（OSA）患者与接受上气道刺激（UAS）治疗的患者。
比较接受传统睡眠手术和 UAS 的回顾性队列患者的病例对照研究，纳入 ADHERE 登记处。
8 个多国家学术医疗中心。
233 名接受过传统单水平或多水平睡眠手术且符合研究纳入标准的患者与 ADHERE 登记处的 465 名接受 UAS 的患者进行比较。我们比较了术前和术后的人口统计学、生活质量和多导睡眠图数据。我们还评估了治疗反应率。
传统睡眠手术组的术前和术后呼吸暂停低通气指数（AHI）分别为 33.5 和 15，UAS 组分别为 32 和 10。UAS 组术后 AHI 明显更低。传统睡眠手术组和 UAS 组的术前和术后嗜睡评分（ESS）分别为 12 和 6。亚组分析评估了接受单水平腭和多水平腭和舌基传统睡眠手术的患者。UAS 组术后 AHI 明显低于传统睡眠手术的两个亚组。UAS 组达到手术成功的患者比例更高，定义为术后 AHI<20，与术前严重程度相比降低了 50%。
UAS 比传统睡眠手术显著更好地控制 AHI 严重程度。两组患者的生活质量改善情况相似。
