Ysunza A, Garcia-Velasco M, Garcia-Garcia M, Haro R, Valencia M
Department of Phoniatrics, Hospital Gea Gonzalez, Mexico City, D.F., Mexico.
Cleft Palate Craniofac J. 1993 Jul;30(4):387-90. doi: 10.1597/1545-1569_1993_030_0387_osasts_2.3.co_2.
The files of 585 patients who had had pharyngeal flap surgery for the correction of velopharyngeal insufficiency were reviewed. Eighteen patients, ranging in age from 6 to 16 years, showed clinical symptoms of obstructive sleep apnea syndrome. All of these cases had a polysomnographic evaluation and videonasopharyngoscopy. Fifteen cases met the criteria for the diagnosis of obstructive sleep apnea syndrome and eventually underwent surgical treatment. A modified uvulopalatopharyngoplasty was done in 14 of the 15 cases. One patient had a prominent uvula flipping into the port of a Jackson's type pharyngoplasty, so a partial resection of the uvula was performed. Surgical treatment was successful in 14 of 15 cases, including the case with the partial uvular resection. In one case, severe sleep apnea persisted after surgery and a complete section of the flap was performed to correct the obstruction. Sizeable tonsils were found in 13 out of 15 cases, whereas flap width appeared unrelated to obstruction. Preoperative assessment of tonsillar tissue is of vital importance before pharyngeal flap surgery.
回顾了585例行咽瓣手术矫正腭咽闭合不全患者的病历。18例年龄在6至16岁之间的患者出现阻塞性睡眠呼吸暂停综合征的临床症状。所有这些病例均进行了多导睡眠图评估和鼻咽喉镜检查。15例符合阻塞性睡眠呼吸暂停综合征的诊断标准，最终接受了手术治疗。15例中的14例行改良悬雍垂腭咽成形术。1例患者悬雍垂突出，翻入杰克逊型咽成形术的术野，因此行悬雍垂部分切除术。15例中有14例手术治疗成功，包括行悬雍垂部分切除术的病例。1例患者术后仍有严重睡眠呼吸暂停，遂行咽瓣完全切断术以纠正梗阻。15例中有13例发现扁桃体肿大，而咽瓣宽度似乎与梗阻无关。咽瓣手术前对扁桃体组织进行术前评估至关重要。
