Hospital Universitario Dr. Peset, Avenida Gaspar Aguilar 90, 46017, Valencia, Spain.
Hospital Lluis Alcanyis, Carrer Xàtiva, Km 2, Xàtiva, 46800, Valencia, Spain.
Eur Arch Otorhinolaryngol. 2022 Jan;279(1):373-380. doi: 10.1007/s00405-021-06781-x. Epub 2021 Apr 2.
Although upper airway surgery in selected patients with obstructive sleep apnea (OSA) has been shown to be beneficial, its long-term effects have been questioned. The main objective was to evaluate whether results following surgery remain stable over time, both in objective and subjective terms. As a secondary aim, such stability was also measured in relation with the type of surgery performed.
This work constitutes a retrospective study of OSA adult patients subjected to the following surgical procedures: different types of pharyngoplasties, tongue-base surgery, partial epiglottectomy or hyoid suspension. Those who exclusively underwent tonsillectomy or nasal surgery were excluded. Before surgery, a sleep study, and an assessment of the patients' sleepiness and quality of life were performed, which were repeated at 8, 34, and 48 months after surgery. A total of 153 patients was included.
Following surgery, the apnea-hypopnea index decreased from 34.84/h to 14.54/h and did not vary more than one point in subsequent controls (p = 0.01). The oxygen desaturation index changed from 31.02/h to 14.0/h and remained stable in the second (15.34/h) and third (11.43/h) controls (p = 0.01). Parameters measuring sleepiness and well-being demonstrated the maintenance of long-term benefits. New pharyngoplasties were observed to be more stable than classic pharyngoplasties in the long term (p = 0.04). Single-level surgeries were found to be more stable than multilevel surgeries, although a statistically significant difference was not observed (p = 0.07).
The benefits obtained remained stable in the long term. In our sample, modern pharyngoplasty techniques showed superiority over the classic ones regarding long-term stability.
尽管选择性地对上气道阻塞性睡眠呼吸暂停（OSA）患者进行手术治疗已被证明是有益的，但长期效果仍存在疑问。主要目的是评估手术后的结果是否在客观和主观方面都能随时间保持稳定。次要目标是测量这种稳定性与所进行的手术类型之间的关系。
这是一项对接受以下手术的 OSA 成年患者进行的回顾性研究：各种类型的咽成形术、舌基底手术、部分会厌切除术或舌骨悬吊术。仅接受扁桃体切除术或鼻手术的患者被排除在外。在手术前，对患者进行睡眠研究，并评估其嗜睡和生活质量，这些评估在手术后 8、34 和 48 个月时重复进行。共纳入 153 例患者。
手术后，呼吸暂停低通气指数从 34.84/h 降至 14.54/h，随后的随访中变化不超过 1 个点（p=0.01）。氧减指数从 31.02/h 降至 14.0/h，在第二次（15.34/h）和第三次（11.43/h）随访中保持稳定（p=0.01）。测量嗜睡和幸福感的参数表明长期获益得以维持。长期来看，新型咽成形术比经典咽成形术更稳定（p=0.04）。单水平手术比多水平手术更稳定，但差异无统计学意义（p=0.07）。
长期以来，获益保持稳定。在我们的样本中，现代咽成形术技术在长期稳定性方面优于经典技术。
