Department of Otolaryngology - Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Division of Pediatric Otolaryngology - Head and Neck Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Chicago, IL, 60611, USA.
J Otolaryngol Head Neck Surg. 2022 Mar 14;51(1):11. doi: 10.1186/s40463-022-00562-0.
The purpose of this study was to evaluate the efficacy of sleep endoscopy-directed simultaneous lingual tonsillectomy and epiglottopexy in patients with sleep disordered breathing (SDB), including polysomnography (PSG) and swallowing outcomes.
A retrospective review was performed of all patients undergoing simultaneous lingual tonsillectomy and epiglottopexy over the study period. PSG objective measures were recorded pre- and postoperatively, along with demographic data, comorbidities, and descriptive data of swallowing dysfunction in the postoperative setting.
A total of 24 patients met inclusion criteria for consideration, with 13 having valid pre- and postoperative PSG data. Successful surgery was achieved in 84.6% of patients, with no difference based on presence of medical comorbidities including Trisomy 21. Median reduction in obstructive apnea-hypopnea index (oAHI) with the procedure was 69.9%. Four patients (16.7%) had postoperative concern for dysphagia, but all objective swallowing evaluations were normal and no dietary modifications were necessary.
Combination lingual tonsillectomy and epiglottopexy in indicated patients has a high rate of success in this single-institutional study without new dysphagia in this population. These procedures are amenable to a combination surgery in appropriately selected patients determined by sleep state endoscopy in the setting of SDB evaluated with drug-induced sleep endoscopy.
本研究旨在评估睡眠内镜引导下同时行舌扁桃体切除术和会厌悬吊术治疗睡眠呼吸障碍（SDB）患者的疗效，包括多导睡眠图（PSG）和吞咽结果。
对研究期间所有接受同时行舌扁桃体切除术和会厌悬吊术的患者进行回顾性分析。记录术前和术后的 PSG 客观指标，以及人口统计学数据、合并症和术后吞咽功能障碍的描述性数据。
共有 24 例患者符合纳入标准，其中 13 例有有效的术前和术后 PSG 数据。84.6%的患者手术成功，是否存在包括 21 三体综合征在内的合并症并无差异。该手术使阻塞性呼吸暂停低通气指数（oAHI）中位数降低了 69.9%。4 例（16.7%）患者术后出现吞咽困难，但所有客观吞咽评估均正常，无需调整饮食。
在本单中心研究中，对于有适应证的患者，联合行舌扁桃体切除术和会厌悬吊术成功率较高，且该人群无新出现的吞咽困难。在药物诱导睡眠内镜评估的 SDB 睡眠状态内镜检查中，对于合适选择的患者，这些手术可联合进行。
