Hellemans Simon, Van de Perck Eli, Van Loo Dorine, Verbraecken Johan, Sands Scott A, Azarbarzin Ali, Dieltjens Marijke, Op De Beeck Sara, Vroegop Anneclaire, Vanderveken Olivier M
Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, 2610 Antwerp, Belgium.
ENT, Head and Neck Surgery, Antwerp University Hospital, 2650 Edegem, Belgium.
Life (Basel). 2024 Jul 31;14(8):963. doi: 10.3390/life14080963.
Surgical interventions, like barbed reposition pharyngoplasty (BRP), are a valuable alternative for patients with obstructive sleep apnea (OSA) who are unable to tolerate continuous positive airway pressure (CPAP). However, predicting surgical success remains challenging, partly due to the contribution of non-anatomical factors. Therefore, combined medical treatment with acetazolamide, known to stabilize respiratory drive, may lead to superior surgical results. This double-blind, parallel-group randomized controlled trial evaluates the efficacy of acetazolamide as an add-on therapy to BRP in OSA. A total of 26 patients with moderate to severe OSA undergoing BRP were randomized to receive either acetazolamide or placebo post-surgery for 16 weeks. The group who was treated with BRP in combination with acetazolamide showed a reduction in AHI of 69.4%, significantly surpassing the 32.7% reduction of the BRP + placebo group ( < 0.01). The sleep apnea-specific hypoxic burden also decreased significantly in the group who was treated with BRP + acetazolamide ( < 0.01), but not in the group receiving BRP + placebo ( = 0.28). Based on these results, acetazolamide as an add-on therapy following BRP surgery shows promise in improving outcomes for OSA patients, addressing both anatomical and non-anatomical factors.
手术干预，如倒刺复位咽成形术（BRP），对于无法耐受持续气道正压通气（CPAP）的阻塞性睡眠呼吸暂停（OSA）患者来说是一种有价值的替代方案。然而，预测手术成功率仍然具有挑战性，部分原因是非解剖学因素的影响。因此，联合使用已知可稳定呼吸驱动的乙酰唑胺进行药物治疗，可能会带来更好的手术效果。这项双盲、平行组随机对照试验评估了乙酰唑胺作为BRP辅助治疗OSA的疗效。共有26例接受BRP的中重度OSA患者被随机分为两组，术后分别接受乙酰唑胺或安慰剂治疗16周。接受BRP联合乙酰唑胺治疗的组AHI降低了69.4%，显著超过BRP+安慰剂组32.7%的降低幅度（<0.01）。接受BRP+乙酰唑胺治疗的组睡眠呼吸暂停特异性低氧负担也显著降低（<0.01），而接受BRP+安慰剂治疗的组则没有降低（=0.28）。基于这些结果，乙酰唑胺作为BRP手术后的辅助治疗，在改善OSA患者的治疗效果方面显示出前景，可同时解决解剖学和非解剖学因素。
