Division of Head & Neck Surgery/Otolaryngology, Department of Comprehensive Medical Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan.
Department of Otolaryngology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Sleep Breath. 2024 May;28(2):869-875. doi: 10.1007/s11325-023-02926-w. Epub 2023 Oct 4.
The aim of this study was to evaluate the efficacy of uvulopalatopharyngoplasty (UPPP) and the corresponding postoperative morphometrical changes.
Patients diagnosed with obstructive sleep apnea syndrome who complained of snoring and apnea were enrolled in this study. Pre- and postoperative tests, including CTs, pharyngeal volume (PV), cross-sectional area (CSA), and six-category morphometrical studies, were performed.
Of 11 patients included, 10 showed improvement of symptoms. BMI correlated with the respiratory event index (REI). In terms of PV, there was a significantly wider postoperative area. The rate of change between preoperative REI and postoperative REI (ΔREI) correlated with the amount of change of PV between preoperative PV and postoperative PV (ΔPV). CSA increased postoperatively and correlated with REI. Uvula space (UV) and distance between the hyoid bone and the base of the tongue (HB) increased postoperatively, and posterior airway space (PAS) and epiglottic space (Epi) decreased postoperatively. UV and PAS were significant (p = 0.046, 0.014). UV was related to REI.
Widening the PV, increasing CSA, and the posterior movement of the tongue base after UPPP surgery were found. The improvement of REI did not depend only on volume. These results suggest that it was important not only to widen the PV but also to improve the shape of the pharynx.
本研究旨在评估悬雍垂腭咽成形术（UPPP）的疗效及其术后相应的形态学变化。
本研究纳入了被诊断为阻塞性睡眠呼吸暂停综合征并抱怨打鼾和呼吸暂停的患者。进行了术前和术后测试，包括 CT、咽部容积（PV）、横截面积（CSA）和六类形态学研究。
11 例患者中，10 例症状改善。BMI 与呼吸事件指数（REI）相关。在 PV 方面，术后区域明显变宽。术前 REI 与术后 REI 的变化率（ΔREI）与术前 PV 与术后 PV 的变化量（ΔPV）相关。CSA 术后增加，并与 REI 相关。悬雍垂空间（UV）和舌骨与舌根底部之间的距离（HB）术后增加，而后气道空间（PAS）和会厌空间（Epi）术后减小。UV 和 PAS 有显著差异（p = 0.046，0.014）。UV 与 REI 相关。
UPPP 手术后发现 PV 增宽、CSA 增加和舌骨后移。REI 的改善不仅取决于体积。这些结果表明，不仅要拓宽 PV，还要改善咽部的形状，这一点很重要。
