头颈部癌症放疗后的阻塞性睡眠呼吸暂停。
Obstructive sleep apnoea after radiotherapy for head and neck cancer.
机构信息
Unit of Otorhinolaryngology, Head and Neck Surgery, Humanitas San Pio X, Milan, Italy.
出版信息
Acta Otorhinolaryngol Ital. 2020 Oct;40(5):338-342. doi: 10.14639/0392-100X-N0895.
OBJECTIVE
The aim of this study is to focus attention on obstructive sleep apnoea hypopnoea syndrome (OSHAS) as a sequela of non-surgical treatments of selected head and neck cancer (HNca), sharing our experience in drug-induced sleep endoscopy (DISE). To the best of our knowledge, this is the first study that documents dynamic anatomical and functional alterations during sleep in irradiated OSAHS patients by DISE.
METHODS
A retrospective study of patients affected by OSAHS referring to our department from January 2018 to December 2019 was carried out. Inclusion criteria were: patients who underwent radiation or chemo-radiation for HNca affecting upper airways that presented sleep-related breathing disorders after treatment.
RESULTS
6 patients with moderate to severe OSAHS and a clinical story of previous non-surgical treatment for an HNca were enrolled. DISE showed in all patients typical anatomical alterations observed in irradiated individuals. Four patients were treated with continuous positive airway pressure, while 2 subjects were treated with tailored minimal invasive surgery without post-operative complications.
CONCLUSIONS
Our results suggest that minimal invasive surgical treatments can be a good therapeutic option in very selected patients with post-irradiation iatrogenic OSAHS.
目的
本研究旨在关注阻塞性睡眠呼吸暂停低通气综合征（OSHAS）作为某些头颈部癌症（HNca）非手术治疗的后遗症，分享我们在药物诱导睡眠内镜（DISE）方面的经验。据我们所知，这是第一项通过 DISE 记录接受放射治疗的 OSAHS 患者睡眠期间动态解剖和功能改变的研究。
方法
对 2018 年 1 月至 2019 年 12 月期间因 OSAHS 就诊于我院的患者进行回顾性研究。纳入标准为：因影响上呼吸道的 HNca 接受放疗或放化疗，治疗后出现与睡眠相关的呼吸障碍的患者。
结果
共纳入 6 例中重度 OSAHS 患者，均有 HNca 非手术治疗的临床病史。DISE 显示所有患者均存在放射治疗个体中观察到的典型解剖改变。4 例患者接受持续气道正压通气治疗，2 例患者接受微创量身定制手术治疗，无术后并发症。
结论
我们的结果表明，微创外科治疗可能是放射后医源性 OSAHS 非常选定患者的一种良好治疗选择。
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