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欧洲睡眠外科专家关于打鼾和阻塞性睡眠呼吸暂停的共识声明:第3部分 腭部手术、结果与随访、并发症及术后管理

Consensus Statements among European Sleep Surgery Experts on Snoring and Obstructive Sleep Apnea: Part 3 Palatal Surgery, Outcomes and Follow-Up, Complications, and Post-Operative Management.

作者信息

Olszewska Ewa, De Vito Andrea, Heiser Clemens, Vanderveken Olivier, O'Connor-Reina Carlos, Baptista Peter, Kotecha Bhik, Vicini Claudio

机构信息

Department of Otolaryngology, Sleep Apnea Surgery Center, Medical University of Bialystok, 15-276 Bialystok, Poland 2 Department of Surgery, Morgagni-Pierantoni Hospital, Health Local Agency of Romagna, 47121 Forlì, Italy 3 Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerp, Belgium 4 Department of Otorhinolaryngology/Head and Neck Surgery, Klinikum Rechts der Isar, Technical University of Munich, 80333 München, Germany 5 Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, 2650 Antwerp, Belgium 6 Hospitales Quironsalud Marbella, 29603 Malaga, Spain 7 Departmento de Orl, Clinica Universidad da Navarra, 31008 Pamplona, Spain.

Department of Surgery, Morgagni-Pierantoni Hospital, Health Local Agency of Romagna, 47121 Forlì, Italy.

出版信息

J Clin Med. 2024 Sep 13;13(18):5438. doi: 10.3390/jcm13185438.

Abstract

Exploring and establishing a consensus on palatal surgery, the outcomes and follow-up after the palatal surgery, the complications of palatal surgery, and the post-operative management after palatal surgery for snoring and obstructive sleep apnea (OSA) among sleep surgeons is critical in the surgical management of patients with such conditions. Using the Delphi method, a set of statements was developed based on the literature and circulated among a panel of eight European experts. Responses included agreeing and disagreeing with each statement, and the comments were used to assess the level of consensus and to develop a revised version. The new version with the level of consensus and anonymized comments was sent to each panel member as the second round. This was repeated over a total of five rounds. The final set included a total of 111 statements, 27 of which were stand-alone questions and 21 of which contained 84 sub-statements. Of the 34 statements regarding palatal surgery, consensus was achieved among all eight, seven, and six panelists for 50%, 35.3%, and 5.9% of the questions, respectively. Of the 43 statements regarding the outcomes and follow-up after the palatal surgery, consensus was achieved among all eight, seven, and six panelists for 53.5%, 23.3%, and 4.7% of the questions, respectively. Of the 24 statements regarding complications after the palatal surgery, consensus was achieved among all eight, seven, and six panelists for 91.7%, 0%, and 4.2% of the questions, respectively. Of the 10 statements regarding post-operative management after palatal surgery, consensus was achieved among all eight, seven, and six panelists for 10%, 30%, and 30% of the papers, respectively. This consensus provides an overview of the work of European sleep surgeons to develop a set of statements on palatal surgery for the treatment of snoring and OSA, the outcomes and follow-up, the complications, and the post-operative management of palatal surgery. We believe that this will be helpful in everyday practice. It also indicates key areas for further studies in sleep surgery.

摘要

对于睡眠外科医生而言,探索并就腭裂手术、腭裂手术后的结果与随访、腭裂手术的并发症以及腭裂手术后针对打鼾和阻塞性睡眠呼吸暂停(OSA)的术后管理达成共识,对于此类疾病患者的手术治疗至关重要。采用德尔菲法,基于文献制定了一组陈述,并在由八位欧洲专家组成的小组中传阅。回复包括对每条陈述的同意或不同意,这些评论用于评估共识程度并制定修订版。带有共识程度和匿名评论的新版本作为第二轮发送给每位小组成员。总共重复进行了五轮。最终的陈述集共有111条陈述,其中27条是独立问题,21条包含84个子陈述。在34条关于腭裂手术的陈述中,八位、七位和六位专家分别对50%、35.3%和5.9%的问题达成了共识。在43条关于腭裂手术后结果与随访的陈述中,八位、七位和六位专家分别对53.5%、23.3%和4.7%的问题达成了共识。在24条关于腭裂手术后并发症的陈述中,八位、七位和六位专家分别对91.7%、0%和4.2%的问题达成了共识。在10条关于腭裂手术后术后管理的陈述中,八位、七位和六位专家分别对10%、30%和30%的陈述达成了共识。这一共识概述了欧洲睡眠外科医生为制定一套关于治疗打鼾和OSA的腭裂手术、结果与随访、并发症以及腭裂手术术后管理的陈述所做的工作。我们相信这将有助于日常实践。它还指出了睡眠外科进一步研究的关键领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a97/11431938/61b3ba328757/jcm-13-05438-g001.jpg

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