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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Lateral oropharyngeal wall and supraglottic airway collapse associated with failure in sleep apnea surgery.
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Lateral oropharyngeal wall and supraglottic airway collapse associated with failure in sleep apnea surgery.

机译：口咽外侧壁和声门上气道塌陷与睡眠呼吸暂停手术失败有关。

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OBJECTIVES/HYPOTHESIS: To identify patterns of airway collapse during preoperative drug-induced sleep endoscopy (DISE) as predictors of surgical failure following multilevel airway surgery for patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). STUDY DESIGN: Retrospective clinical chart review. METHODS: Medical records of patients who underwent site-specific surgical modification of the upper airway for treatment of OSHAS were reviewed. Patients were included in this study if they had a preoperative airway evaluation with DISE as well as preoperative and postoperative polysomnography. Airway obstruction on DISE was described according to airway level, severity, and axis of collapse. Severe airway obstruction was defined as >75% collapse on endoscopy. Surgical success was described as a postoperative apnea-hypopnea index (AHI) of <20 and a >50% decrease in preoperative AHI. RESULTS: A total of 34 patients were included in this study. The overall surgical success rate was 56%. Surgical success (n = 19) and surgical failure (n = 15) patients were similar with regard to age, gender, body mass index, preoperative AHI, Friedman stage, adenotonsillar grades, and surgical management. DISE findings in the surgical failure group demonstrated greater incidence of severe lateral oropharyngeal wall collapse (73.3% vs. 36.8%, P = .037) and severe supraglottic collapse (93.3% vs. 63.2%, P = .046) as compared to the surgical success group. CONCLUSIONS: The presence of severe lateral pharyngeal wall and/or supraglottic collapse on preoperative DISE is associated with OSAHS surgical failure. The identification of this failure-prone collapse pattern may be useful in preoperative patient counseling as well as in directing an individualized and customized approach to the treatment of OSHAS.
机译：目的/假设：为了确定阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者接受多级气道手术后术前药物诱发的睡眠内窥镜检查（DISE）期间气道塌陷的模式，作为手术失败的预测指标。研究设计：回顾性临床图表审查。方法：回顾了接受上呼吸道特定部位手术治疗OSHAS的患者的病历。如果患者进行了术前DISE评估以及术前和术后多导睡眠图检查，则将其纳入本研究。根据气道高度，严重程度和塌陷轴描述了DISE上的气道阻塞。严重的气道阻塞定义为内窥镜检查> 75％塌陷。手术成功被描述为术后呼吸暂停低通气指数（AHI）<20，术前AHI下降> 50％。结果：本研究共纳入34例患者。总体手术成功率为56％。在年龄，性别，体重指数，术前AHI，Friedman分期，腺扁桃体分级和手术管理方面，手术成功（n = 19）和手术失败（n = 15）的患者相似。与手术组相比，手术失败组的DISE结果显示，严重的口咽外侧侧壁塌陷（73.3％vs. 36.8％，P = .037）和严重的声门上塌陷（93.3％vs. 63.2％，P = .046）的发生率更高。手术成功小组。结论：术前DISE上存在严重的咽外侧侧壁和/或声门上塌陷与OSAHS手术失败有关。这种容易失败的崩溃模式的识别可能对术前患者咨询以及指导个性化和定制化的OSHAS治疗方法很有用。

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