基于高级的后喉叶片:使用护理途径来优化语音和气道结果
James Butterfield1, Megan Pencek, Keith Sweitzer
1From the Division of Plastic Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY.
Annals of plastic surgery
|April 1, 2024
概括
这项研究表明,一种用于喉 (PF) 手术的新方案,包括分阶段腺切除术和患者特定的PF大小测量,有效地改善了语音结果,同时最大限度地降低了阻塞性睡眠呼吸暂停 (OSA) 的风险.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 语音语言病理学 语言病理学
- 睡眠医学 睡眠医学
背景情况:
- 喉 (PF) 手术有效地治疗喉缺陷 (VPI).
- 历史数据表明,在PF手术后,患上阻塞性睡眠呼吸暂停 (OSA) 的风险很大,患病率高达20%.
- 为了提高手术安全性和减少术后阻塞性并发症,开发了一种新的协议.
研究的目的:
- 为了评估修改后的PF手术方案在改善语音结果方面的有效性.
- 根据修改的PF外科手术方案,评估OSA的发生率.
- 测试假设,手术前腺切除术和患者特异性PF维度可以产生优秀的语音结果与有限的OSA风险.
主要方法:
- 对41名接受PF手术 (2015-2022) 的VPI患者 (年龄在2-20岁) 的回顾性图表审查.
- 手术前的评估包括鼻镜检查,对于高的患者,至少在手术前2个月进行了分阶段的腺切除术.
- 多视图视频光学引导PF大小测定;术前和术后 (≥6个月) 进行了多睡眠和语音评估.
主要成果:
- 在PF手术后没有观察到阻塞性呼吸暂停-呼吸暂停指数的显著增加 (1.3对1.7事件/小时,P=0.111).
- 记录了语言结果的显著改善 (修改后的匹兹堡得分:11.52前期和1.09后期,P<0.05).
- 该队列包括22q11.2删除和皮埃尔·罗宾序列的儿童.
结论:
- 实施的协议结合了阶段性腺切除术和患者特定的PF维度,有效地解决了VPI.
- 这种方法显著改善了语音功能,同时保持了发展阻塞性睡眠呼吸暂停的低风险.
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