Upper airway changes in obstructive sleep apnea suffers after H-uvulopalatopharyngoplasty and H-uvulopalatopharyngoplasty combined with transpalatal advancement phayngoplasty
10.3760/cma.j.issn.1673-0860.2013.04.006
- VernacularTitle:悬雍垂腭咽成形术联合软腭前移术后气道结构变化的研究
- Author:
Jia-Jia DONG
1
;
Jing-Ying YE
;
Jun-Bo ZHANG
;
Xin CAO
;
Jun-Long TAN
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
- Keywords:
Sleep apnea,obstructive;
Otorhinolaryngologic surgical procedures;
Tomography,X-ray computed
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2013;48(4):289-294
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the different postoperative changes of the pharynx in obstructive sleep apnea hypopnea syndrome (OSAHS) patients treated with H-uvulopalatopharyngoplasty (H-UPPP) combined with transpalatal advancement pharyngoplasty (PA) surgery or H-UPPP alone.Methods The upper airway in 43 patients with OSAHS were scanned during the end of normal respiration before and after treatment.There were 17 patients undergoing H-UPPP alone,26 patients undergoing H-UPPP combined with PA,with PSG before and after treatment.To compare the efficacy of H-UPPP with PA surgery or H-UPPP alone,upper airway characteristics were measured following each procedure in 43 patients using a quantitative 3-D CT.The 3-D CT measurement were made in lateral and anterior-posterior diameters,crosssection areas and volumes of retropalatal and retroglossal region.The changes in the structure of OSAHS patients treated with H-UPPP combined with PA surgery and H-UPPP alone were compared preoperatively and postoperatively,and the correction features that were presented in AHI and structural changes were analysed.Results The difference between H-UPPP combined with PA (n =26) and H-UPPP (n =17) in the changes in apnea hypopnea index (AHI) were (67.5 ± 18.9,38.7 ± 42.0,t =2.84,P ＜ 0.05),hard palate lengths were (4.50 ± 3.72) mm and (0.06 ± 0.22) mm (t =5.55,P ＜ 0.01) ; anteroposterior diameters of the hard palate level were (3.5 ± 4.3) mm and (-1.7 ± 4.4) mm(t =3.90,P ＜ 0.01) ; the minimum anteroposterior diameters of retropalatal were (1.2 ± 2.2) mm and (-1.2 ± 2.3) mm (t =-3.49,P ＜ 0.01) ; the minimum lateral diameters of retroglossal area were (4.9 ± 9.6) mm and (13.1 ±9.1)mm (t =2.80,P ＜ 0.01) preoperatively and postoperatively.The changes in the hard palate lengths were positively correlated to the change in AHI (r =0.407,P ＜ 0.01),also the change in anteroposterior diameter of the hard palate level (r =0.351,P ＜ 0.05),the minimum anteroposterior diameter of retropalatal area (r =0.381,P ＜ 0.01),and the minimum cross-section area of retropalatal (r =0.312,P ＜0.05).Conclusions H-UPPP combined with PA offers benefit over H-UPPP alone in OSAHS patients,which may be achieved by increased retropalatal airway size.Both the anteroposterior dimensions and the cross-area size are related with the efficacy of surgery.
