Ellis P D, Williams J E, Shneerson J M
Addenbrooke's Hospital, Cambridge.
Ann R Coll Surg Engl. 1993 Jul;75(4):286-90.
We describe our experience in the surgical treatment of 32 patients with severe snoring. In the first 16 patients we used the standard surgical procedure of uvulopalatopharyngoplasty (UPP) but found this unsatisfactory because of its radical nature, complications and uncertain outcome. We therefore investigated the mechanics of snoring in the laboratory as a help in devising a more effective operation. These studies have shown that there are several methods by which snoring can be generated but that palatal flutter is probably the most important. The dominant parameters in the generation of flutter of the palate are its length and stiffness. Any removal of tissue to shorten the palate as in UPP inevitably risks impairing its function, so we chose the stiffening alternative. Using the laser, a central longitudinal strip of mucosa was removed from the surface of the soft palate which healed by fibrosis, producing the required stiffening. The early results of this new procedure show that snoring has been eliminated or greatly reduced in 14 of 16 patients and that apart from local pain there have been no complications.
我们描述了对32例重度打鼾患者进行外科治疗的经验。在前16例患者中,我们采用了悬雍垂腭咽成形术(UPP)的标准手术方法,但由于其根治性、并发症和不确定的结果,发现这种方法并不令人满意。因此,我们在实验室研究了打鼾的机制,以帮助设计一种更有效的手术。这些研究表明,有几种方法可以产生打鼾,但软腭颤动可能是最重要的。软腭颤动产生的主要参数是其长度和硬度。正如UPP那样,任何切除组织以缩短软腭的做法都不可避免地有损害其功能的风险,所以我们选择了加强的方法。使用激光,从软腭表面切除一条中央纵向粘膜带,通过纤维化愈合,产生所需的硬化。这一新手术的早期结果表明,16例患者中有14例打鼾已消除或大大减轻,除了局部疼痛外,没有其他并发症。