Otolaryngology, Asia Sleep Centre, Paragon, Singapore, Singapore.
General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
J Otolaryngol Head Neck Surg. 2024 Jan-Dec;53:19160216241279074. doi: 10.1177/19160216241279074.
OBJECTIVE.: A new critical complication risk analysis, the reasonable risk ratio (RRR or R) for palate surgeries in obstructive sleep apnea patients.
METHODS.: Analysis from published meta-analyses, systematic reviews on success rates, and complications encountered for 3 palate surgeries, expansion sphincter pharyngoplasty (ESP), barbed repositioning pharyngoplasty (BRP) and modified uvulopalatopharyngoplasty (mUPPP), over 20 years. The RRR is derived from a ratio of the percentage of each respective complication over the success rate of that particular surgical procedure. The benchmark RRR of tonsillectomy is set at 0.035 to 0.078. An RRR below this benchmark value is more favorable as tonsillectomy is a widely accepted ENT procedure with risks to benefit well accepted.
RESULTS.: The RRR for foreign body (FB) sensation (BRP) ranged from 0.03 to 0.23 (mean RRR of 0.14), FB sensation (ESP) 0.01, FB sensation (mUPPP) ranged from 0.33 to 0.55 (mean RRR of 0.44). The RRR for swallowing difficulties (BRP) ranged from 0.04 to 0.23 (mean RRR of 0.11), mUPPP, was 0.37; no reported swallowing difficulties with the ESP. The RRR for velopharyngeal insufficiency (VPI) (BRP) ranged from 0.009 to 0.18 (mean RRR of 0.07), and RRR VPI (mUPPP) was 0.14. The RRR (BRP) for dry throat was 0.06 and the mUPPP was 0.35, with no reported VPI or dry throat for ESP. The overall RRR for the BRP was 0.09, ESP was 0.01 and mUPPP was 0.29.
CONCLUSION.: RRR provides a summarized data-driven, statistical guide to aid decision-making, and helps in patient counseling. BRP and ESP have been shown to have less complications compared to mUPPP. IV.
分析一种新的严重并发症风险，即阻塞性睡眠呼吸暂停患者行腭部手术的合理风险比（RRR 或 R）。
分析 20 多年来 3 种腭部手术（扩张咽括约肌成形术（ESP）、带刺复位咽成形术（BRP）和改良悬雍垂腭咽成形术（mUPPP））的成功率和并发症的已发表荟萃分析和系统评价。RRR 是通过比较特定手术的并发症百分比与成功率得出的比值。扁桃体切除术的基准 RRR 值设定为 0.035 至 0.078。低于此基准值的 RRR 更有利，因为扁桃体切除术是一种广泛接受的耳鼻喉科手术，其风险与益处已被广泛接受。
异物感（BRP）的 RRR 范围为 0.03 至 0.23（平均 RRR 为 0.14），异物感（ESP）为 0.01，异物感（mUPPP）为 0.33 至 0.55（平均 RRR 为 0.44）。吞咽困难（BRP）的 RRR 范围为 0.04 至 0.23（平均 RRR 为 0.11），mUPPP 为 0.37；ESP 无吞咽困难报告。腭咽闭合不全（VPI）（BRP）的 RRR 范围为 0.009 至 0.18（平均 RRR 为 0.07），mUPPP 的 RRR 为 0.14。BRP 组的咽干 RRR 为 0.06，mUPPP 组为 0.35，ESP 组无 VPI 或咽干报告。BRP 的总体 RRR 为 0.09，ESP 为 0.01，mUPPP 为 0.29。
RRR 提供了一种数据驱动的总结，有助于做出决策，并为患者咨询提供帮助。与 mUPPP 相比，BRP 和 ESP 的并发症较少。IV。
