Elasfour A, Miyazaki S, Itasaka Y, Yamakawa K, Ishikawa K, Togawa K
Department of Otorhinolaryngology-Head & Neck Surg., Faculty of Medicine, Mansoura University, Egypt.
Acta Otolaryngol Suppl. 1998;537:52-6. doi: 10.1080/00016489850182369.
Many methods have been reported to select the proper candidates for uvulopalatopharyngoplasty (UPPP) among obstructive sleep apnea patients. Polysomnography with intraluminal pressure recordings in the upper airway was found useful to predict obstructive site(s) and hence the success of surgery. According to the pressure analysis, 11 cases with high negative pressure at the mesopharynx were selected for UPPP, while UPPP combined with midline partial glossectomy (UPPP-MLG) was done in 18 cases proved to have high negative pressure difference between the mesopharynx and esophagus. A reduction of the apnea hypopnea index (AHI) of more than 50% after UPPP was found in 8 cases (72.7%) and in 11 cases (61.l%) after UPPP-MLG. It was found that the response rate was lower among the second group if compared to that of the first because of other aggravating factors rather than simple obstruction at the level of the soft palate and or tonsils-tongue base level.
在阻塞性睡眠呼吸暂停患者中,已有多种方法被报道用于选择腭咽成形术(UPPP)的合适候选人。发现上气道腔内压力记录的多导睡眠图有助于预测阻塞部位,从而预测手术的成功率。根据压力分析,选择11例在中咽部出现高负压的患者进行UPPP,而对18例被证明在中咽部和食管之间存在高负压差的患者进行UPPP联合中线部分舌切除术(UPPP-MLG)。UPPP术后呼吸暂停低通气指数(AHI)降低超过50%的有8例(72.7%),UPPP-MLG术后有11例(61.1%)。结果发现,与第一组相比,第二组的反应率较低,原因是存在其他加重因素,而非单纯软腭和/或扁桃体-舌根水平的阻塞。