2.Therapeutic effects of oral appliance combined with uvulopalatopharyngoplasty on obstructive sleep apnea hypopnea syndrome.
Jianxing HAN ; Bei WANG ; Yunfang AN ; Yuan MA ; Yan LIU ; Yufeng MA
Chinese Journal of Stomatology 2014;49(2):69-72
OBJECTIVETo explore the long-term effects of the uvulopalatopharyngoplasty (UPPP) combined with oral appliance (OA) in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS).
METHODSThirty patients with severe OSAHS confirmed by polysomnography (PSG) according to their apnea hypopnea index (AHI) and lowest SaO2 during sleep were selected using random permutation table and divided into only UPPP group(U group, n = 15) and UPPP with OA group (UA group, n = 15). The follow-up period was 2 years. PSG was performed in 0.5 year and 2 years after operation. AHI, lowest SaO2 and Tmax were tested and evaluated.
RESULTSThe effectiveness of two groups was the same after 0.5 year. Two years after operation, the values [AHI: (18.06 ± 2.24) times/h; lowest SaO2: (88.64 ± 10.37)% and Tmax: (20.5 ± 17.6) s] in UA group were better than that [AHI: (49.73 ± 3.35) times/h; lowest SaO2: (79.56 ± 4.87)% and Tmax: (41.3 ± 19.7) s] in U group. The number of effectiveness was 9 and the number of ineffectiveness was 6 in U group, while in UA group, the number of effectiveness was 14 and the number of ineffectiveness was 1(P < 0.05).
CONCLUSIONSLong-term result of combined treatment was better than that of UPPP only.
Humans ; Orthodontic Appliances ; Palate ; surgery ; Pharynx ; surgery ; Polysomnography ; Sleep ; Sleep Apnea, Obstructive ; surgery ; Uvula ; surgery
3.Uvulopalatopharyngoplasty and hyoid suspension for obstructive sleep apnea hyponea syndrome.
Yungang WU ; Hui ZHANG ; Taizhang PANG ; Panpan SONG ; Xiaoyu LI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(24):1972-1974
OBJECTIVE:
The aim of this study was to investigate the clinical efficacy of uvulopalatopharyngoplasty (UPPP) with hyoid suspension for patients with obstructive sleep apnea hypopnea syndrome (OSAHS).
METHOD:
Thirty-eight OSAHS patients underwent UPPP with hyoid suspension. Review the sleep monitoring after 6 months and 1 year and compare the AHI, LSaO 2 and ESS score.
RESULT:
The average AHI decreased, and blood oxygen saturation increased significantly afer operation.
CONCLUSION
UPPP with hyoid suspension is an available and relatively safe surgical approach in OSAHS patients.
Humans
;
Palate
;
surgery
;
Pharynx
;
surgery
;
Sleep
;
Sleep Apnea, Obstructive
;
surgery
;
Uvula
;
surgery
7.Tongue base surgery with front neck access and uvulopalatopharyngoplasty for treatment of severe obstructive sleep apnea-hypopnea syndrome.
Qing-Quan ZHANG ; Xi-Cheng SONG ; Tian-Zhen ZHANG ; Yan SUN ; Hua ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2005;40(9):704-705
Adult
;
Aged
;
Female
;
Humans
;
Male
;
Middle Aged
;
Otorhinolaryngologic Surgical Procedures
;
methods
;
Sleep Apnea, Obstructive
;
surgery
;
Tongue
;
surgery
;
Uvula
;
surgery
8.Effect of mouth breathing on upper airway structure in patients with obstructive sleep apnea.
Yanru LI ; Nanxi FEI ; Lili CAO ; Yunhan SHI ; Junfang XIAN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(7):529-534
Objective:To compare the changes of morphology of pharynx in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and healthy individuals during oral or nasal breathing, and explore the relevant influencing factors. Methods:Twenty-nine adult patients with OSAHS and 20 non-snoring controls underwent MRI to obtain upper airway structural measurements while the subjects were awake and during mouth breathing with a nasal clip.The following were analyzed. ①The changes of upper airway structure of oral and nasal respiration in non-snoring control/OSAHS patients were observed; ②The differences and influencing factors of upper airway structure changes between OSAHS patients and controls were compared during breathing. Results:The control group consisted of 15 males and 5 females, with an apnea-hypopnea index (AHI)<5 events/h, while the OSAHS group comprised 26 males and 3 females with an AHI of 40.4±23.1 events/h and the mean lowest arterial oxygen saturation (LSaO2) was 79.5% ±10.0%. In the both groups, the vertical distance between the mandible and the posterior pharyngeal wall decreased (P<0.05); The long axis of tongue body decreased (P<0.05), and the contact area between tongue and palate decreased. There was no significant change in the total volume of the retropalatine(RP) and retroglossal(RG) airway in the control group (P>0.05). However, the minimum cross-sectional area and volume of the RP airway in OSAHS decreased (P<0.001). The lateral diameters of uvula plane in OSAHS decreased during mouth breathing, which was contrary to the trend in the control group (P=0.017). The AHI of patients was positively correlated with the reduction of the volume of the RP airway during oral breathing (P=0.001); The reduction of the distance between the mandible and the posterior pharyngeal wall was positively correlated with the length of the airway (P<0.001). Conclusion:Mouth breathing leads to the shortening of the long axis of the tongue, the reduction of the contact area between the soft palate and the tongue, vertical distance between the mandible and the posterior pharyngeal wall, and the cross-sectional area of the epiglottis plane. These changes vary between OSAHS patients and controls. During mouth breathing, the diameters, areas and volumes of the RP area decreased, and were more significant in severe cases.
Male
;
Adult
;
Female
;
Humans
;
Mouth Breathing
;
Sleep Apnea, Obstructive/surgery*
;
Pharynx/surgery*
;
Palate, Soft
;
Uvula/surgery*
;
Syndrome
9.Combination of genioglossus advancement by non-trephine technic with uvulopalatopharyngoplasty for treatment of obstructive sleep apnea-hypopnea syndrome.
Shi-Cai CHEN ; Song SHI ; Hong-Liang ZHENG ; Dong-Hui CHEN ; Min-Hui ZHU ; Fei LIU ; Hai-Hong TANG ; Kai WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2009;44(10):815-818
OBJECTIVETo evaluate the efficacy and reliability of genioglossus advancement and hyoid suspension with non-trephine technic (GAHM) and uvulopalatopharyngoplasty (UPPP) for surgical obstructive sleep apnea-hypopnea syndrome treatment.
METHODSTwenty-six patients (4 female and 22 male) were classified as moderate and severe cases in terms of apnea hypopnea index (AHI) and Friedman classification in the present study. All cases patients underwent genioglossus advancement and hyoid suspension with non-trephine technic Uvulopalatopharyngoplasty UPPP. Pre- and postoperative polysomnography and Epworth sleepiness scale were performed to assess the therapeutic outcomes.
RESULTSThe whole operation time ranged from 120-180 minutes. The average amount of bleeding in genioglossus advancement was about 50-100 ml. There were no severe complications during and after the operation. All the cases were followed up to one year. After surgery, AHI was decreased in both group cases, (42.9 +/- 6.6 vs 16.2 +/- 5.7) in the severe group, and 21.3 +/- 4.4 vs 11.3 +/- 5.2 (x(-) +/- s) in the moderate group. With success defined as AHI decreased by more than 50 per cent after surgery, the total success rate in moderate and severe group was 83.3% and 91.7%, respectively (P < 0.01). Furthermore, the success rate of the moderate group was higher than those of the severe group (P < 0.01).
CONCLUSIONGAHM combined with UPPP may be beneficial for the moderate and severe OSAHS patients with oropharyngeal and hypopharyngeal obstruction.
Adult ; Chin ; surgery ; Female ; Humans ; Hyoid Bone ; surgery ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Palate, Soft ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Tongue ; surgery ; Uvula ; surgery
10.Effect of hyoid suspension with uvulopalatopharyngoplasty in the treatment of obstructive sleep apnea hypopnea syndrome.
Qing-quan ZHANG ; Hua ZHANG ; Zhong-lu LIU ; Qiang WANG ; Xi-cheng SONG ; Tian-zhen ZHANG ; Yan SUN ; Shao-hong JIANG ; Li WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2011;46(7):556-560
OBJECTIVETo discuss the methodology and therapeutic effect of hyoid suspension in association with uvulopalatopharyngoplasty (UPPP) in the treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS).
METHODSSixty-nine patients with severe OSAHS (apnea hyponea index, AHI > 30) were treated with hyoid suspension and UPPP. Sixty-one patients were followed for 6 months (48 of them for 12 months). Polysomnogram (PSG) tests were performed and an Epworth sleepiness scale (ESS) was recorded preoperatively and postoperatively in these patients.
RESULTSAfter the surgery,the snoring of the patients disappeared or was alleviated to varing degrees. Eighteen patients underwent fiberoptic nasopharyngolaryngoscopic examination. Twelve of them showed palatopharyngeal and glossopharyngeal stenosis was improved 6 months after surgery. Six patients showed no change, but had no glossoptosis. Fourteen patients underwent fiberoptic nasopharyngolaryngoscopic examination 1 year after surgery, with no recurrence of the stenosis being found. A decrease of 50% in the AHI was considered effective, and in patients the effective rate was 78.7% (48/61) 6 months after the operation and 75.0% (36/48) 1 year after the operation. The average AHI decreased from 44.8 to 15.1 and 17.2, and the minimum arterial oxygen saturation average increased from 0.512 to 0.880 and 0.730. Matching t tests were utilized and the results of follow-up indicated that there was a significant improvement in the indexes in those cases which could be followed up (P < 0.01). The average of the ESS was 6.7 six months after operation and 7.2 one year after operation, with a significant decrease compared to the preoperative (16.6) data (P < 0.01).
CONCLUSIONSModified hyoid suspension in association with UPPP has the advantage of a simple operation, short hospitalization and less expense, and the effect of the operation was significant. Patients with palatopharyngeal and glossopharyngeal stenosis should be chosen for this operation.
Adult ; Aged ; Female ; Humans ; Hyoid Bone ; surgery ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Palate, Soft ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Thyroid Cartilage ; surgery ; Uvula ; surgery