Five-Year Objective and Subjective Outcomes of Velopharyngeal Surgery for Patients with Obstructive Sleep Apnea
Five-Year Objective and Subjective Outcomes of Velopharyngeal Surgery for Patients with Obstructive Sleep Apnea
复制标题
阻塞性睡眠呼吸暂停患者腭咽手术的五年客观和主观结果
DOI：
10.1177/0194599819884889
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发表时间：
2020-01
期刊：
影响因子：
--
通讯作者：
Ye J
中科院分区：
文献类型：
--
作者：
Yin GP;He M;Cao X;Xu JK;Zhang YH;Kang D;Ye J
目的评价经手术治疗阻塞性睡眠呼吸暂停综合征（OSA）患者的远期疗效。研究设计：前瞻性队列研究。设置大学医学中心。对象和方法86例OSA患者接受了咽手术，其中包括保留悬雍垂的改良悬雍垂腭咽成形术，同时进行或不进行经腭推进咽成形术。比较6个月和5年后多导睡眠图和埃普沃思睡眠量表的结果。比较应答者和无应答者的基线变量。结果63例患者均获得随访。6个月和5年后的手术成功率分别为66.67%（42/63）和60.32%（38/63），无显著差异（P = 0.459）。治疗6个月和5年后，应答者和无应答者的呼吸暂停低通气指数和埃普沃思睡眠量表较基线显著降低（所有P <0.001）。与无应答者相比，应答者表现出较大的扁桃体大小、较高的夜间最低氧饱和度、较低的CT 90（氧饱和度<90%的时间百分比）和较短的MH（计算机断层扫描正中矢状面中下颌骨下缘与舌骨之间的垂直距离）。扁桃体大小和CT 90对手术成功具有显著的预测价值（P <0.001）。结论经6个月和5年随访，腭咽闭合手术可有效改善OSA患者的夜间呼吸和日间过度嗜睡。扁桃体大小和CT 90可作为手术反应者的预测指标。
Objective To assess the long-term effects of velopharyngeal surgery on objective and subjective symptoms in patients with obstructive sleep apnea (OSA). Study Design Prospective cohort study. Setting University medical center. Subjects and Methods Eighty-six patients with OSA underwent velopharyngeal surgery, which consisted of revised uvulopalatopharyngoplasty with uvula preservation, with or without concomitant transpalatal advancement pharyngoplasty. The results from polysomnography and the Epworth Sleep Scale after 6 months and 5 years were compared with baseline. Baseline variables were compared between responders and nonresponders. Results Sixty-three patients were successfully followed up at the end of study. The surgical success rate after 6 months and 5 years was 66.67% (42 of 63) and 60.32% (38 of 63), respectively, with no significant difference (P = .459). The apnea-hypopnea index and Epworth Sleep Scale dramatically decreased from baseline after 6 months and 5 years in responders and nonresponders (P < .001 for all). As compared with nonresponders, the responders exhibited larger tonsil size, higher nocturnal lowest oxygen desaturation, lower CT90 (percentage of time with oxygen saturation <90%), and shorter MH (vertical distance between the lower edge of the mandible and hyoid in the midsagittal plane of computed tomography). Tonsil size and CT90 showed significant predictive value for surgery success (P < .001 for both). Conclusion Velopharyngeal surgery was effective in improving nocturnal respiration and excessive daytime sleepiness in patients with OSA at 6-month and 5-year follow-up. Tonsil size and CT90 could be predictors for surgery responders.
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影响因子：
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作者：
Yousuf A;Beigh Z;Khursheed RS;Jallu AS;Pampoori RA
通讯作者：
Pampoori RA
DOI：
10.1177/0194599815625210
发表时间：
2016-03
期刊：
Otolaryngology–Head and Neck Surgery
影响因子：
--
作者：
J. Barrera;G. Dion
通讯作者：
J. Barrera;G. Dion
DOI：
--
发表时间：
2011-06
期刊：
The Medical journal of Malaysia
影响因子：
--
作者：
W. H. Aneeza;M. Marina;M. Y. Razif;N. A. Azimatun;A. Asma;A. Sani
通讯作者：
W. H. Aneeza;M. Marina;M. Y. Razif;N. A. Azimatun;A. Asma;A. Sani
DOI：
10.1288/00005537-199411000-00008
发表时间：
1994-11
期刊：
The Laryngoscope
影响因子：
--
作者：
L. Håkan Larsson;B. Carlsson‐Nordlander;E. Svanborg
通讯作者：
L. Håkan Larsson;B. Carlsson‐Nordlander;E. Svanborg
影响因子：
9.6
作者：
HE, J;KRYGER, MH;ROTH, T
通讯作者：
ROTH, T