改良咽侧成形术治疗阻塞性睡眠呼吸暂停低通气综合征初步疗效分析

A study of modified lateral pharyngoplasty for the treatment of obstructive sleep apnea hypopnea syndrome: primary outcomes analysis

目的：对咽侧成形术进行改进,术中切断部分腭帆提肌,行高位软腭成形术。探讨改良咽侧成形术以及手术的初步疗效。方法：回顾性分析接受改良咽侧成形术的以口咽部狭窄为主的60例阻塞性睡眠呼吸暂停低通气综合征患者的临床资料,包括体检、Epworth嗜睡评分、PSG、纯音测听和咽鼓管功能检查、治疗结果、并发症和随访结果。结果：术后有效6例（6/60,10%）,显效44例（44/60,73.3%）,治愈10例（10/60,16.7%）,总有效率为100%。术后出血2例（3.3%）。短期腭咽闭合不全10例（16.7%）。术后随访6~12个月,无腭咽闭合不全,无咽鼓管功能障碍,无鼻咽狭窄。结论：改良咽侧成形术对于以口咽狭窄为主的各种程度的OSAHS是安全有效的。

Objective：To describe a modified lateral pharyngoplasty with partial transsection of levator veli palatine muscle in patients with obstructive sleep apnea hypopnea syndrome（OSAHS） and report the primary outcomes.Method：Retrospective review was performed in sixty patients with OSAHS.All the patients underwent modified surgical procedures,including partial transsection of levator veli palatine muscle and high soft palatoplasty.Result：The patients with a reduction of the AHI at least 50% were 6（6/60,10%）.The patients with a reduction of the AHI at least 50% and a postoperative AHI 20 were 44（44/60,73.3%）.The patients with a postoperative AHI 5 were 10（10/60,16.7%）.Postoperative complications were postoperative bleeding in two cases（3.3%） and short-term velopharyngeal insufficience in 10 cases（16.7%）.Conclusion：Lateral pharyngoplasty with partial transsection of levator veli palatine muscle provides a safe and effective procedure for selected OSAHS patients with oropharyngeal collapse as the main site.