<strong>Backgroun</strong><strong>d</strong><strong>:</strong> Obstructive sleep apnea (OSA) has cardiovascular, neurological, and social complications. Surgical treatment has the p...<strong>Backgroun</strong><strong>d</strong><strong>:</strong> Obstructive sleep apnea (OSA) has cardiovascular, neurological, and social complications. Surgical treatment has the potential to improve airway patency but when and which surgery should be done is a controversy. <strong>Aims and objective<strong>s</strong></strong><strong>:</strong> To estimate the site of obstruction in patients with OSAS and to assess the surgical results of the site (of obstruction) directed surgical treatment.<strong> Methodology: </strong>Twenty patients with OSAS were included in the study with Eight adults and Twelve children. It was a prospective study. All patients were assessed for the airway collapse and surgery was done accordingly. Repeat PSG was done after surgery for success rate after 4 months of follow up. <strong>Result:</strong> 17 patients successfully completed the follow-up. Four (50%) adults and Two (17%) children have grade I or II tonsils while Four (50%) of adults and Ten (83%) children have tonsil size grade III or IV. Seven (88%) adults and one (8%) of the children have adenoid hypertrophy up to grade II. One adult (12%) and nine children (75%) have grade III Adenoid size. Two children (17%) have Adenoid grade IV size. In Four patients retropalatal more than retroglossal collapse was found (50%). One patient (12%) had retroglossal more than retropalatal collapse other one had only retropalatal collapse, and the other one had retroglossal collapse. ESS (Epworth sleepiness scale) decreased postoperatively in both groups. There is a significant change in AHI with the median pre-op AHI being 40.19 to median post-op AHI being 11.35 with a p-value 0.017. Apnea-hypopnea index (AHI) in children pre-operatively was 12.98 (median) changed to 2.15 (median) which is statistically significant. Only one adult patient (12%) is surgically cured while in five patients (63%) surgical success achieved with a surgical success rate of 5/8 (63%). Whereas only one patient is surgically cured 1/8 (13%). Eight patients achieved surgical success with a total success rate of 8/9 (89%). While only two patients achieved surgical cure (23%) among children. Conclusion: The outcome of site-directed surgical treatment is that it is a satisfactory way of treatment of OSAS with an overall success rate of 76%.展开更多
目的:比较阻塞性睡眠窒息症(OSA)患者和正常人的图形视网膜电图(PERG)和图形视觉诱发电位(PVEP)。方法:前瞻性横断面研究。研究包含马来西亚医科大学的40例OSA患者和31例正常人。随机选取眼部未发生病变并确诊OSA的患者参与研究。通过...目的:比较阻塞性睡眠窒息症(OSA)患者和正常人的图形视网膜电图(PERG)和图形视觉诱发电位(PVEP)。方法:前瞻性横断面研究。研究包含马来西亚医科大学的40例OSA患者和31例正常人。随机选取眼部未发生病变并确诊OSA的患者参与研究。通过记录呼吸暂停低通气指数(AHI)以用于对OSA的严重程度分层。由马来西亚医科大学眼科电生理实验室内训练有素的技术人员对每位患者进行电生理检查(PVEP和PERG)。所得结果记录为中位数。使用IBM Statistics Version 21.0完成数据分析。结果:在OSA患者中,与正常人相比,我们观察到PERG的P50振幅(P<0.001)和PVEP的P100振幅(P<0.001)显著降低。OSA患者PVEP的P100(P=0.003)和N75的峰值时间(P=0.004)均显著升高。然而在OSA患者和正常人之间的PERG的峰值时间检测无显著差异。在不同疾病严重程度的OSA患者中PVEP或PERG也无显着差异。结论:OSA患者PVEP幅度和峰值时间及PERG幅度存在显著异常。这可能反映了OSA中的亚临床视神经功能障碍。展开更多
文摘<strong>Backgroun</strong><strong>d</strong><strong>:</strong> Obstructive sleep apnea (OSA) has cardiovascular, neurological, and social complications. Surgical treatment has the potential to improve airway patency but when and which surgery should be done is a controversy. <strong>Aims and objective<strong>s</strong></strong><strong>:</strong> To estimate the site of obstruction in patients with OSAS and to assess the surgical results of the site (of obstruction) directed surgical treatment.<strong> Methodology: </strong>Twenty patients with OSAS were included in the study with Eight adults and Twelve children. It was a prospective study. All patients were assessed for the airway collapse and surgery was done accordingly. Repeat PSG was done after surgery for success rate after 4 months of follow up. <strong>Result:</strong> 17 patients successfully completed the follow-up. Four (50%) adults and Two (17%) children have grade I or II tonsils while Four (50%) of adults and Ten (83%) children have tonsil size grade III or IV. Seven (88%) adults and one (8%) of the children have adenoid hypertrophy up to grade II. One adult (12%) and nine children (75%) have grade III Adenoid size. Two children (17%) have Adenoid grade IV size. In Four patients retropalatal more than retroglossal collapse was found (50%). One patient (12%) had retroglossal more than retropalatal collapse other one had only retropalatal collapse, and the other one had retroglossal collapse. ESS (Epworth sleepiness scale) decreased postoperatively in both groups. There is a significant change in AHI with the median pre-op AHI being 40.19 to median post-op AHI being 11.35 with a p-value 0.017. Apnea-hypopnea index (AHI) in children pre-operatively was 12.98 (median) changed to 2.15 (median) which is statistically significant. Only one adult patient (12%) is surgically cured while in five patients (63%) surgical success achieved with a surgical success rate of 5/8 (63%). Whereas only one patient is surgically cured 1/8 (13%). Eight patients achieved surgical success with a total success rate of 8/9 (89%). While only two patients achieved surgical cure (23%) among children. Conclusion: The outcome of site-directed surgical treatment is that it is a satisfactory way of treatment of OSAS with an overall success rate of 76%.
文摘目的:比较阻塞性睡眠窒息症(OSA)患者和正常人的图形视网膜电图(PERG)和图形视觉诱发电位(PVEP)。方法:前瞻性横断面研究。研究包含马来西亚医科大学的40例OSA患者和31例正常人。随机选取眼部未发生病变并确诊OSA的患者参与研究。通过记录呼吸暂停低通气指数(AHI)以用于对OSA的严重程度分层。由马来西亚医科大学眼科电生理实验室内训练有素的技术人员对每位患者进行电生理检查(PVEP和PERG)。所得结果记录为中位数。使用IBM Statistics Version 21.0完成数据分析。结果:在OSA患者中,与正常人相比,我们观察到PERG的P50振幅(P<0.001)和PVEP的P100振幅(P<0.001)显著降低。OSA患者PVEP的P100(P=0.003)和N75的峰值时间(P=0.004)均显著升高。然而在OSA患者和正常人之间的PERG的峰值时间检测无显著差异。在不同疾病严重程度的OSA患者中PVEP或PERG也无显着差异。结论:OSA患者PVEP幅度和峰值时间及PERG幅度存在显著异常。这可能反映了OSA中的亚临床视神经功能障碍。
