Mickelson S A, Rosenthal L
Atlanta Ear Nose and Throat Associates, GA 30342, U.S.A.
Laryngoscope. 1997 May;107(5):614-9. doi: 10.1097/00005537-199705000-00011.
Obstructive sleep apnea syndrome is caused by narrowing of the pharyngeal airway and loss of dilator tone during sleep. In patients with severe apnea surgical correction often requires attention to both the oropharynx and hypopharynx. Tongue reduction surgery has been described for persistent apnea after failure of palatal surgery. We describe our experience with midline glossectomy with epiglottidectomy in 12 patients with a mean age of 48.8 +/- 14.2 years and body mass index of 36.0 +/- 8.8 kg/m2. Response to treatment was defined as a postoperative respiratory disturbance index (RDI) below 20. Three patients (25%) responded to treatment. The mean apnea index decreased from 48.9 to 35.7, RDI decreased from 73.3 to 46.6, and lowest oxygen saturation increased from 65.9 to 77.9%. RDI in responders decreased from 69.7 to 10. Midline glossectomy with epiglottidectomy has variable results, yet is effective in selected patients with hypopharyngeal narrowing related to macroglossia.
阻塞性睡眠呼吸暂停综合征是由睡眠期间咽部气道狭窄和扩张肌张力丧失引起的。对于重度呼吸暂停患者，手术矫正通常需要同时关注口咽和下咽。腭部手术失败后持续存在呼吸暂停的患者可采用舌缩小手术。我们描述了12例平均年龄为48.8±14.2岁、体重指数为36.0±8.8kg/m²的患者接受中线舌切除术联合会厌切除术的经验。治疗反应定义为术后呼吸紊乱指数（RDI）低于20。3例患者（25%）对治疗有反应。平均呼吸暂停指数从48.9降至35.7，RDI从73.3降至46.6，最低血氧饱和度从65.9%升至77.9%。有反应患者的RDI从69.7降至10。中线舌切除术联合会厌切除术效果不一，但对部分因巨舌症导致下咽狭窄的患者有效。
