Efficacy of Han-uvulopalatopharyngoplasty (HUPPP) combined with radiofrequency ablation of tongue base or HUPPP with traction of tongue base on moderate to severe patients with obstructive sleep apnea hypopnea syndrome (OSAHS):a multicenter randomized controlled trial.
10.3760/cma.j.cn115330-20210429-00237
- VernacularTitle:HUPPP联合舌根射频消融术或舌根牵引术治疗中重度OSAHS的疗效对比研究：一项多中心随机对照试验
- Author:
Wen Jun YU
1
;
Hua Ming ZHU
1
;
Hua Jun XU
1
;
Jian Yin ZOU
1
;
Xin Yi LI
1
;
Yu Pu LIU
1
;
Li Li MENG
1
;
Su Ru LIU
1
;
Jian GUAN
1
;
Hong Liang YI
1
;
Ji Ping LI
2
;
Pin DONG
3
,
4
;
Shan Kai YIN
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China.
2. Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Renji Hospital, Shanghai 200001, China.
3. Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai 200080, China
4. Correspongding author: Yin Shankai.
- Publication Type:Randomized Controlled Trial
- MeSH:
China;
Humans;
Oxygen Saturation;
Radiofrequency Ablation;
Sleep Apnea, Obstructive/surgery*;
Tongue/surgery*;
Traction
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2021;56(12):1248-1255
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the therapeutic efficacy of Han-uvulopalatopharyngoplasty (HUPPP) combined with radiofrequency ablation of tongue base or HUPPP with traction of tongue base on moderate to severe patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: This is a multicenter randomized controlled trial. From March 2017 to July 2019, moderate to severe OSAHS patients from three clinical center in Shanghai who were intolerant to continuous positive airway pressure (CPAP) and with velopharyngeal and glossopharyngeal plane obstruction were enrolled in this study. According to the surgical type, they were 1∶1 randomized to HUPPP plus radiofrequency ablation of tongue base group (Ablation group) or HUPPP plus traction of tongue base group (Traction group). All patients completed over-night standard Polysomnography (PSG), upper-airway assessment (Friedman classification, Müller test, CT and cephalometric examination), preoperative routine examination, Epworth Sleepiness Scale (ESS) and Quebec sleep questionnaire (QSQ). Six to 12 months after operation, all the above-mentioned examinations were repeatedly performed. Changes of aforementioned variables before and after operation were assessed. Results: A total of 43 patients with moderate to severe OSAHS were enrolled in this study. One patient lost to follow-up, the remaining 21 were allocated to Ablation group and 21 were allocated to Traction group. The total therapeutic efficacy of all patients was 69.05% (61.90% in Ablation group and 76.19% in Traction group), but there was no statistical significance between the two groups (P= 0.317). The value of sleep scale score (ESS and QSQ), objective sleep variables (apnea-hypopnea index, oxygen saturation, percentage of time with blood oxygen less than 90% in total sleep time, oxygen desaturation index and micro-arousals) and upper airway cross-sectional area (palatopharyngeal and retrolingual area) of the two groups were improved (P<0.05), but the differences between the two groups were not statistically significant (P>0.05). Conclusion: For moderate to severe OSAHS who had glossopharyngeal plane obstruction, both HUPPP plus radiofrequency ablation of tongue base or HUPPP plus traction of tongue base are effective treatment for OSAHS, and the curative effect is similar. The choice of surgical type could be selected according to patient's or surgical conditions.
