Effects of hyoid position on surgical treatment outcome for patients with obstructive sleep apnea hypopnea syndrome
10.3760/cma.j.issn.1673-0860.2015.04.004
- VernacularTitle:舌骨位置对预测阻塞性睡眠呼吸暂停低通气综合征腭部手术疗效的作用
- Author:
Xin CAO
1
;
Jingying YE
;
Junbo ZHANG
;
Junlong TAN
;
Jiajia DONG
Author Information
1. 100730,首都医科大学附属北京同仁医院耳鼻咽喉头颈外科 耳鼻咽喉头颈科学教育部重点实验室
- Keywords:
Sleep apnea,obstructive;
Otorhinolaryngologic surgical procedures;
Hyoid bone;
Treatment outcome
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2015;50(4):281-285
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the predictive value of the position of the hyoid in surgical outcomes of velopharyngeal surgery for obstructive sleep apnea hypopnea syndrome (OSAHS).Methods The polysomnography,CT,and anthropometry data were retrospectively reviewed from patients who underwent revised uvulopalatopharyngoplasty with uvula preservation (H-UPPP) simply or the combination of H-UPPP and transpalatal advance pharyngoplasty (TAP) for OSAHS from July 2008 to December 2011.OSAHS was diagnosed by polysomnography(PSG) in 128 patients who underwent H-UPPP or H-UPPP with TAP surgery for their sleep disorder.After surgical treatment,the patients were evaluated by PSG.Results The 128 patients included were all male,the mean age of these patients was (39.6-± 8.5) years,ranged from 19 to 66 years.Seventy-seven patients were successfully treated and 51 did not respond to surgical treatment.The overall apnea hypopnea index (AHI)improved from (58.2-± 22.4)times/h preoperatively to (20.6 ± 18.1)times/h postoperatively (t =14.9,P ＜ 0.001).The vertical distance from inferior margin of hyoid to the inferior mandibular margin (D-HM) was the only parameter that had a significant difference between responders [(14.6 ± 7.7) mm] and non-responders [(19.4-± 8.0) mm] (t =3.452,P =0.001).D-HM,AHI and the lowest blood oxygen saturation were significant predictors of surgical outcomes (P ＜0.05).There was a significant correlation between the D-HM and the postoperative AHI (r =0.284,P =0.001).The D-HM of ≥ 23 mm could predict the postoperative AHI of ＞ 10 times/h a specificity of 95.2％.Conclusion The D-HM is a negative predictor of surgical outcomes,patients with a D-HM of ≥23 mm are inappropriate candidates for velopharryngeal surgery.
