Zhao Di, Li Yanru, Xian Junfang, Lin Zhihong, Lou Zhewei, Cao Xin, Kang Dan, Ye Jingying
Department of Otorhinolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, HangZhou, Zhejiang, China.
Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Acta Otolaryngol. 2023 Apr;143(4):322-327. doi: 10.1080/00016489.2023.2197685. Epub 2023 Apr 24.
It is uncertain which factors substantially influence outcomes after uvulopalatopharyngoplasty (UPPP) in patients with supine predominant obstructive sleep apnea (POSA).
To explore the predictors of UPPP outcomes in POSA patients.
A total of 108 patient(52 positional patients (POSA) and 56 nonpositional patients(NPP)), who underwent the revised uvulopalatopharyngoplasty (H-UPPP), were retrospectively studied. The pre-operative information of these patients, including polysomnography (PSG), and upper airway CT, were collected for analysis.
No difference was found in surgical success rates between POSA and NPP undergoing H-UPPP. In POSA patients, there were statistically significant differences between responders and nonresponders in body mass index (BMI), preoperative supine AHI, time of SaO2 < 90% (TS90) (all < .05), minimal anteroposterior airway (mAP) ( = .016), minimal lateral airway (mLAT) ( = .002), minimal cross-sectional airway area (mCSA) ( < .001) at the velopharynx. mLAT ( = .014) and mCSA ( = .002) at the glossopharynx. The independent associated factors for surgical success were lower BMI ( < .001), narrowerm LAT ( = .002) and mAP ( < .001) at velopharynx, and wider mCSA ( < .001) at glossopharynx in POSA.
POSA patients with lower BMI, narrower mLAT and mAP at velopharynx, wider mCSA at glossopharynx were more likely to achieve a positive outcome with H-UPPP.
对于仰卧位为主的阻塞性睡眠呼吸暂停（POSA）患者，悬雍垂腭咽成形术（UPPP）后哪些因素会对手术结果产生重大影响尚不确定。
探讨POSA患者UPPP手术结果的预测因素。
回顾性研究了108例行改良悬雍垂腭咽成形术（H-UPPP）的患者（52例体位性患者（POSA）和56例非体位性患者（NPP））。收集这些患者的术前信息，包括多导睡眠图（PSG）和上气道CT，进行分析。
接受H-UPPP的POSA患者和NPP患者的手术成功率没有差异。在POSA患者中，反应者和无反应者在体重指数（BMI）、术前仰卧位呼吸暂停低通气指数（AHI）、血氧饱和度<90%的时间（TS90）（均<0.05）、腭咽最小前后径气道（mAP）（=0.016）、腭咽最小侧径气道（mLAT）（=0.002）、腭咽最小横截面积气道（mCSA）（<0.001）方面存在统计学显著差异。在舌咽，mLAT（=0.014）和mCSA（=0.002）也存在差异。POSA患者手术成功的独立相关因素是较低的BMI（<0.001）、腭咽较窄的mLAT（=0.002）和mAP（<0.001），以及舌咽较宽的mCSA（<0.001）。
BMI较低、腭咽mLAT和mAP较窄、舌咽mCSA较宽的POSA患者更有可能通过H-UPPP获得良好的手术结果。
