Application of drug-induced sleep endoscopy in predicting the outcomes of velopharyngeal surgery in adult patients with Friedman stage II and III obstructive sleep apnea syndrome.
Application of drug-induced sleep endoscopy in predicting the outcomes of velopharyngeal surgery in adult patients with Friedman stage II and III obstructive sleep apnea syndrome.
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药物诱导睡眠内镜在预测Friedman II期和III期阻塞性睡眠呼吸暂停综合征成人患者腭咽手术结局中的应用
DOI：
10.3389/fneur.2022.1049425
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发表时间：
2022
影响因子：
3.4
通讯作者：
Ye, Jingying
中科院分区：
文献类型：
--
作者：
Cao, Xin;Zhou, Yingqian;Zhang, Junbo;Yin, Guoping;Ye, Jingying
关键词：
目的评价药物诱导睡眠内镜（DISE）对Friedman Ⅱ、Ⅲ期阻塞性睡眠呼吸暂停综合征（OSAS）患者咽部手术预后的预测价值。方法对39例男性OSAS患者的临床资料进行回顾性分析。多导睡眠图（PSG）显示呼吸暂停低通气指数（AHI）> 5次/h的受试者和典型症状，如打鼾、睡眠呼吸暂停和白天嗜睡，均纳入本研究。所有患者术前均接受DISE检查，并接受咽手术治疗，采用腭、口咽、舌根和会厌（VOTE）评分系统进行评估。临床、多导睡眠图参数（例如，呼吸不足、呼吸暂停、AHI、最低氧饱和度等），头影测量变量和DISE结果进行了评价。术后至少6个月通过多导睡眠图评估治疗效果。结果39例患者术前DISE检查均显示完全性咽气道塌陷。术后AHI由术前的50.2 ± 21.6次/h改善为19.8 ± 19次/h（P < 0.05）。有23例应答者（59.0%）和16例无应答者（41.0%）。应答组与无应答组的舌咽气道塌陷程度（GA-CD）差异有统计学意义（P < 0.05）。经统计学处理，咽后气道塌陷模式（VA-CP）和GA-CD是治疗效果的独立预测因子（均P < 0.05）。非外侧型VA-CP和II级GA-CD（塌陷程度> 50%）患者的手术成功率明显低于非外侧型VA-CP和II级GA-CD患者（P < 0.05）。结论DISE检查中VA-CP和GA-CD对Friedman Ⅱ、Ⅲ期OSAS患者咽部手术疗效的预测具有重要价值。患有外侧VA-CP和I级GA-CD的患者适合进行咽手术。
Objective This study aimed to evaluate the predictive value of drug-induced sleep endoscopy (DISE) for the outcomes of velopharyngeal surgery in adult patients with Friedman stage II and III obstructive sleep apnea syndrome (OSAS). Methods A total of 39 male OSAS patients with Friedman stage II and III were retrospectively analyzed. Subjects with an apnea-hypopnea index (AHI) > 5 events/h indicated by polysomnography (PSG) and typical symptoms, such as snoring, sleep apnea, and daytime sleepiness, were included in this study. All these patients underwent pre-operative DISE examinations and were treated by velopharyngeal surgery and evaluated by velum, oropharynx, tongue base, and epiglottis (VOTE) scoring system. Clinical, polysomnographic parameters (e.g., hypopnea, apnea, AHI, lowest oxygen saturation, etc.), cephalometric variables, and DISE findings were evaluated. The treatment outcomes were assessed by polysomnography at least 6 months after surgery. Results All 39 patients showed complete velopharyngeal airway collapses during pre-operative DISE examinations. After surgery, the AHI was significantly improved from 50.2 ± 21.6 to 19.8 ± 19 events/h (P < 0.05). There were 23 responders (59.0%) and 16 non-responders (41.0%). The glossopharyngeal airway collapse degree (GA-CD) was significantly different between responders and non-responders (P < 0.05). The velopharyngeal airway collapse pattern (VA-CP) and GA-CD were independently predictive of treatment outcomes (both P < 0.05). Patients with non-lateral VA-CP and grade II GA-CD (collapse degree > 50%) had a significantly lower surgical success rate than those without (P < 0.05). Conclusion The VA-CP and GA-CD in DISE examination are valuable for predicting the treatment outcomes of velopharyngeal surgery in patients with Friedman stage II and III OSAS. Patients with lateral VA-CP and grade I GA-CD are appropriate candidates for velopharyngeal surgery.
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影响因子：
10
作者：
Kohler, Malcolm;Smith, Debbie;Stradling, John R.
通讯作者：
Stradling, John R.
影响因子：
2.6
作者：
Koutsourelakis, Ioannis;Safiruddin, Faiza;de Vries, Nico
通讯作者：
de Vries, Nico
影响因子：
4.3
作者：
Zhang, Junbo;Cao, Xin;Ye, Jingying
通讯作者：
Ye, Jingying
DOI：
10.1002/lary.27655
发表时间：
2019-03
期刊：
The Laryngoscope
影响因子：
--
作者：
Green KK;Kent DT;D'Agostino MA;Hoff PT;Lin HS;Soose RJ;Boyd Gillespie M;Yaremchuk KL;Carrasco-Llatas M;Tucker Woodson B;Jacobowitz O;Thaler ER;Barrera JE;Capasso R;Liu SY;Hsia J;Mann D;Meraj TS;Waxman JA;Kezirian EJ
通讯作者：
Kezirian EJ
影响因子：
4.3
作者：
Berry, Richard B.;Budhiraja, Rohit;Tangredi, Michelle M.
通讯作者：
Tangredi, Michelle M.