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改良悬雍垂腭咽成形术联合射频消融下鼻甲成形术治疗阻塞性睡眠呼吸暂停低通气综合征

Radiofrequency Coblation Inferior Turbinoplasty with Modified UPPP for the Treatment of Obstructive Sleep Apnea-Hypopnea Syndrome.

作者信息

Tian Qiushi, Chu Teng, Pang Mingjie

机构信息

Department of Otolaryngology, Qingdao Municipal Hospital, Qingdao, Shandong, China.

出版信息

Ear Nose Throat J. 2025 May;104(5):293-300. doi: 10.1177/01455613241307525. Epub 2025 Jan 1.

Abstract

To compare the efficacy of surgical treatment in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) involving a standalone modified uvulopalatopharyngoplasty (mUPPP) and radiofrequency coblation inferior turbinoplasty with mUPPP. In this study, a retrospective analysis of 79 OSAHS patients with inferior turbinate hypertrophy and oropharyngeal obstruction undergoing surgical treatment was performed. According to the different surgical methods, the patients were divided into 2 groups (Group A and Group B). Group A included 36 patients treated with standalone mUPPP. Group B included 43 patients treated with mUPPP and bilateral radiofrequency coblation inferior turbinoplasty. Polysomnography (PSG), active anterior rhinomanometry, surgical success rate, and surgical complication were used to assess the patients in 2 groups. The successful surgical result was defined as a 50% or greater decrease in the apnea-hypopnea index (AHI) in postoperative PSG. Before surgery, there were no significant differences in age, gender, neck circumference, body mass index, Friedman tongue position grade, tonsil size grade, Epworth sleepiness scale score, total inferior turbinate size grade, total nasal resistance (TNR), AHI and the lowest O saturation (LSaO) between the 2 groups. After 6 months of follow-up visits, AHI, LSaO, and TNR in Group B showed a significant improvement compared to Group A. The surgical success rate was 76.74% in Group B compared to 52.78% in Group A ( = .025). There was no significant difference in the total surgical complication rate between the 2 groups (13.89% vs 23.26%, = .290). For OSAHS patients with inferior turbinate hypertrophy and oropharyngeal obstruction, radiofrequency coblation inferior turbinoplasty with mUPPP appears to be a more effective surgical method than mUPPP alone.

摘要

比较单纯改良悬雍垂腭咽成形术(mUPPP)与mUPPP联合射频消融下鼻甲成形术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的手术疗效。本研究对79例接受手术治疗的伴有下鼻甲肥大和口咽阻塞的OSAHS患者进行回顾性分析。根据手术方法不同,将患者分为2组(A组和B组)。A组36例患者接受单纯mUPPP治疗。B组43例患者接受mUPPP联合双侧射频消融下鼻甲成形术治疗。采用多导睡眠图(PSG)、主动前鼻测压法、手术成功率和手术并发症对两组患者进行评估。手术成功结果定义为术后PSG中呼吸暂停低通气指数(AHI)降低50%或更多。术前,两组患者在年龄、性别、颈围、体重指数、Friedman舌位分级、扁桃体大小分级、Epworth嗜睡量表评分、下鼻甲总体大小分级、总鼻阻力(TNR)、AHI和最低血氧饱和度(LSaO)方面无显著差异。随访6个月后,B组的AHI、LSaO和TNR较A组有显著改善。B组手术成功率为76.74%,A组为52.78%(P = 0.025)。两组手术总并发症发生率无显著差异(13.89%对23.26%,P = 0.290)。对于伴有下鼻甲肥大和口咽阻塞的OSAHS患者,mUPPP联合射频消融下鼻甲成形术似乎是一种比单纯mUPPP更有效的手术方法。

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