The effect of genioglossus activity to velopharyngeal surgery in patient with obstructive sleep apnea hypopnea syndrome
10.3760/cma.j.issn.1673-0860.2019.06.005
- VernacularTitle: 颏舌肌活性对阻塞性睡眠呼吸暂停低通气综合征患者腭咽部手术疗效的影响
- Author:
Di ZHAO
1
;
Yanru LI
2
;
Yue QU
3
;
Junfang XIAN
4
;
Xin CAO
3
;
Junbo ZHANG
5
;
Jingying YE
3
Author Information
1. Department of Otorhinolaryngology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
2. Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
3. Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
4. Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
5. Department of Otorhinolaryngology Head and Neck Surgery, Peking University First Hospital, Beijng 100034, China
- Publication Type:Journal Article
- Keywords:
Sleep apnea,obstructive;
Otorhinolaryngologic surgical procedures;
Genioglossus;
Velopharyngeal surgery;
Intraoral electrodes
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2019;54(6):421-426
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of genioglossus (GG) activation at sleep onset on the outcome of velopharyngeal surgery in obstructive sleep apnea hypopnea syndrome (OSAHS) patients.
Methods:Thirty-five patients between April 2014 and February 2015 in Beijing Tongren Hospital with OSAHS underwent overnight polysomnography with synchronous genioglossus electromyography (GGEMG) using intraoral electrodes. The upper airway (UA) anatomy was evaluated by three-dimensional computer tomography (3D-CT) in OSAHS patients. Then, all of the patients received velopharyngeal surgery, including revised uvulopalatopharyngoplasty (UPPP) with uvula preservation or UPPP combined transpalatal advancement pharyngoplasty. All patients were followed-up using polysomnography 3-6 months after surgery. T-test or Wilcoxon test were used to compare the variables between groups, and Spearman correlation analysis was used to test the correlation between parameters.
Results:Thirty-five patients received velopharyngeal surgery. Twenty-two patients (62.86%) were responders, and 13 patients (37.14%) were non-responders. Responders had a higher mean GGEMG during sleep onset (15.31±3.74 vs. 9.92±2.93, t=4.504, P=0.001). The decreased AHI was significantly positively related to the sleep onset mean GGEMG (r=0.541, P=0.004) and the change in GGEMG (r=0.422, P=0.028). The decreased AHI was significantly negatively related to the minimal cross sectional airway area (mCSA,ρ=0.629,P=0.000) and the minimal lateral airway dimension (mLAT, ρ=0.484, P=0.009) at velopharynx.
Conclusions:The outcome of velopharyngeal surgery was affected by the mean GGEMG during sleep onset. We speculated that the patient with higher GGEMG at sleep onset and narrower velopharynx were more suitable candidates for velopharyngeal surgery.
