Palatal hybrid surgery for obstructive sleep apnea- state-of-the-art annotation of uvulopalatopharyngoplasty

被引：3

作者：

Li, Hsueh-Yu ^{[1
,2
,12
]}

Tsai, Ming-Shao ^{[2
,3
,4
,5
,6
]}

Lee, Li-Ang ^{[1
,2
]}

Hsin, Li-Jen ^{[1
,2
]}

Lee, Yi-Chan ^{[2
,7
,8
]}

Lin, Wan-Ni ^{[1
,2
]}

Lu, Yi-An ^{[1
,2
]}

Shen, Shih-Chieh ^{[2
,9
,10
]}

Cheng, Wen-Nuan ^{[11
]}

Chaing, Yen-Ting ^{[1
]}

机构：

[1] Chang Gung Mem Hosp Linkou, Sleep Ctr, Dept Otorhinolaryngol Head & Neck Surg, Linkou, Taiwan

[2] Chang Gung Univ, Coll Med, Taoyuan, Taiwan

[3] Chang Gung Mem Hosp Chayi, Dept Otolaryngol Head, Chayi, Taiwan

[4] Chang Gung Mem Hosp Chayi, Dept Neck Surg, Chayi, Taiwan

[5] Chang Gung Univ, Grad Inst Clin Med Sci, Coll Med, Taoyuan, Taiwan

[6] Chang Gung Mem Hosp Chiayi, Hlth Informat & Epidemiol Lab, Chiayi, Taiwan

[7] Chang Gung Mem Hosp Keelung, Dept Otolaryngol Head, Keelung, Taiwan

[8] Chang Gung Mem Hosp Keelung, Dept Neck Surg, Keelung, Taiwan

[9] New Taipei City Municipal Tucheng Hosp, Dept Otolaryngol Head, New Taipei, Taiwan

[10] New Taipei City Municipal Tucheng Hosp, Dept Neck Surg, New Taipei, Taiwan

[11] Univ Taipei, Dept Sports Sci, Taipei, Taiwan

[12] Chang Gung Mem Hosp Linkou, Dept Otorhinolaryngol Head & Neck Surg, 5 Fu Hsing Str, Taoyuan 33305, Taiwan

来源：

BIOMEDICAL JOURNAL | 2023年 / 46卷 / 03期

关键词：

Palatal hybrid surgery; Uvulopalatopharyngoplasty; Omni-suspension of soft palate; Stereoscopic reconstruction of; tonsillar fossa; Push and pull maneuver; Obstructive sleep apnea; POSTOPERATIVE PAIN; RELOCATION PHARYNGOPLASTY; UPPER AIRWAY; COMPLICATIONS; REDUCTION; SEVERITY; EFFICACY; ANATOMY;

D O I：

10.1016/j.bj.2022.11.001

中图分类号：

Q5 [生物化学]; Q7 [分子生物学];

学科分类号：

071010 ; 081704 ;

摘要：

Background: Surgery for obstructive sleep apnea (OSA) has changed in concept and tech-nique that transformed from radical excision to functional reconstruction. The aim of this study was to investigate the safety and effectiveness of palatal hybrid surgery in OSA patients. Methods: Palatal hybrid surgery is a tissue-specific technique (mucosa-preservation, tonsil -excision, fat-ablation, muscle-relocation/suspension) used in treating OSA patients with velopharyngeal obstruction. The study included 46 consecutive adults OSA patients. The palatal hybrid surgery annotates uvulopalatopharyngoplasty in stereoscopic reconstruc-tion of tonsillar fossa (pharyngoplasty), omni-suspension of the soft palate (palatoplasty) and advancement of uvula (uvuloplasty). Results: No patient experienced airway compromise, voice change or persistent nasal regurgitation following palatal hybrid surgery. One patient existed postoperative tonsillar fossa bleeding received conservative treatment. Postoperative pain in visual analogue scale (VAS) showed average score of 3, 3, 2, 0 at the 1st, 3rd, 7th, 14th day, respectively. Peri-operative snoring severity (VAS) (8.7 vs 2.6) and daytime sleepiness (Epworth Sleepiness Scale) (11.3 vs 5.5) all improved significantly (p < 0.001). Posterior air space in retropalatal area increased from 8.4 to 11.1 mm (p < 0.001). Home sleep test showed that apnea-hy-popnea index significantly reduced from 41.8 to 18.2 event/h and minimal oxygen satu-ration increased from 72.4 to 81.5% (p < 0.001). The success rate in individual Friedman stage was 100% (stage I), 63% (stage II) and 58% (stage III) with a total success rate of 63%. Conclusion: Palatal hybrid surgery using tissue-specific maneuver annotates UPPP in concept and technique. The results show that palatal hybrid surgery is mini-invasive with low morbid and is effective in improving subjective clinic symptoms, objective sleep pa-rameters and success rate of OSA.

引用

页数：10

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