Thomas Jefferson University Hospital, Department of Otolaryngology - Head and Neck Surgery, 925 Chestnut St, Philadelphia, PA 19107, United States of America.
Thomas Jefferson University Hospital, Department of Otolaryngology - Head and Neck Surgery, 925 Chestnut St, Philadelphia, PA 19107, United States of America.
Am J Otolaryngol. 2021 Sep-Oct;42(5):103035. doi: 10.1016/j.amjoto.2021.103035. Epub 2021 Apr 7.
Evaluate the rate of complications, readmissions, emergency department presentations, and surgical success rates amongst three standard surgical treatment options for obstructive sleep apnea: upper airway stimulation, transoral robotic surgery, and expansion sphincter pharyngoplasty.
Retrospective cohort.
Tertiary care center.
Patients were included who were aged ≥18 years old and underwent upper airway stimulation, transoral robotic surgery, or expansion sphincter pharyngoplasty between January 2011 and May 2020.
345 patients were identified: 58% (n = 201) underwent upper airway stimulation, 10% (n = 35) underwent transoral robotic surgery, and 32% (n = 109) patients underwent expansion sphincter pharyngoplasty. There were 22 emergency department presentations and 19 readmissions, most of which were experienced by patients receiving transoral robotic surgery (six emergencies, seven readmissions) and expansion sphincter pharyngoplasty (12 emergencies, 11 readmissions). Patients with upper airway stimulation had four emergencies and one readmission. Only 2% of the upper airway stimulation cohort had a complication, whereas this was 20% and 12% for the transoral robotic surgery and expansion sphincter pharyngoplasty cohorts, respectively. Patients experienced the highest surgical success rate with upper airway stimulation (69%), whereas patients who received transoral robotic surgery and expansion sphincter pharyngoplasty had success rates of 50% and 51%, respectively.
Treating obstructive sleep apnea with upper airway stimulation led to lower rates of complications, emergency department presentations, and readmissions in this series. In those for whom upper airway stimulation is appropriate, it may be more effective in successfully treating obstructive sleep apnea than transoral robotic surgery and expansion sphincter pharyngoplasty.
评估三种阻塞性睡眠呼吸暂停标准手术治疗方法（上气道刺激、经口机器人手术和扩张咽括约肌成形术）的并发症、再入院、急诊就诊和手术成功率。
回顾性队列研究。
三级护理中心。
纳入年龄≥18 岁且于 2011 年 1 月至 2020 年 5 月期间接受上气道刺激、经口机器人手术或扩张咽括约肌成形术的患者。
共确定了 345 名患者：58%（n=201）接受上气道刺激，10%（n=35）接受经口机器人手术，32%（n=109）患者接受扩张咽括约肌成形术。共有 22 例急诊就诊和 19 例再入院，其中大多数发生在接受经口机器人手术（6 例急诊就诊，7 例再入院）和扩张咽括约肌成形术的患者中（12 例急诊就诊，11 例再入院）。上气道刺激组的患者有 4 例急诊就诊和 1 例再入院。仅有 2%的上气道刺激组患者出现并发症，而经口机器人手术和扩张咽括约肌成形术组的这一比例分别为 20%和 12%。上气道刺激组患者的手术成功率最高（69%），而接受经口机器人手术和扩张咽括约肌成形术的患者的成功率分别为 50%和 51%。
在本系列中，使用上气道刺激治疗阻塞性睡眠呼吸暂停可降低并发症、急诊就诊和再入院的发生率。在上气道刺激适用的情况下，其治疗阻塞性睡眠呼吸暂停的效果可能优于经口机器人手术和扩张咽括约肌成形术。
