Eplite Angelo, Vicini Claudio, Meccariello Giuseppe, Iannella Giannicola, Maniaci Antonino, Cannavicci Angelo, Moretti Francesco, Facchini Fabio, Mazzocco Tommaso, Cammaroto Giovanni
Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Via GB Grassi 74, 20154 Milan, Italy.
Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini 34, 47121 Forli, Italy.
J Clin Med. 2023 Jun 21;12(13):4173. doi: 10.3390/jcm12134173.
(1) Background: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder and is characterized by recurrent episodes of complete or partial obstruction of the upper airway, leading to reduced or absent breathing during sleep. A nocturnal upper airway collapse is often multi-levelled. The aim of this communication is to describe a 3D multi-level surgery setting in OSA pathology, introducing new surgical approaches, such as 4K-3D endoscopic visualization for the tongue base approach with the aid of a coblator and exoscopic visualization in the palatal approach. (2) Methods: Seven patients affected by OSA underwent 3D Barbed Reposition Pharyngoplasty (BRP) surgery associated with transoral coblation tongue base reduction and nose surgery. (3) Results: No patients experienced intra-operative, post-operative or delayed complications. For OSA multi-level 3D surgery, it took less than 2 h: the median 3D system setting time was 12.5 ± 2.3 min; the overall procedure time was 59.3 ± 26 min. (4) Conclusions: The use of the 4K-3D endoscope and coblator for tongue base resectioning and of the 3D exoscope for lateral pharyngoplasty represents an excellent system in multi-level OSA related surgery that could reduce the time and the costs compared to those of robotic surgery.
(1) 背景：阻塞性睡眠呼吸暂停（OSA）是最常见的与睡眠相关的呼吸障碍，其特征为上气道反复出现完全或部分阻塞发作，导致睡眠期间呼吸减少或停止。夜间上气道塌陷通常是多平面的。本交流的目的是描述OSA病理中的3D多平面手术设置，介绍新的手术方法，如借助消融器进行舌根入路的4K-3D内镜可视化以及腭入路的外视镜可视化。(2) 方法：7例OSA患者接受了3D倒刺复位咽成形术（BRP），并联合经口消融舌根减容术和鼻部手术。(3) 结果：无患者出现术中、术后或延迟并发症。对于OSA多平面3D手术，耗时不到2小时：3D系统设置的中位时间为12.5±2.3分钟；总手术时间为59.3±26分钟。(4) 结论：使用4K-3D内镜和消融器进行舌根切除术以及使用3D外视镜进行外侧咽成形术，在与OSA相关的多平面手术中是一个出色的系统，与机器人手术相比，可减少时间和成本。
