结合桃切除术和低光神经刺激用于睡眠呼吸暂停患者与口腔大侧壁崩
Phillip Huyett1, Andrew Wellman2, Victoria Caruso1
1Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts, USA.
概括
将桃体切除术添加到低分泌神经刺激 (HGNS) 治疗中,显著改善了阻塞性睡眠呼吸暂停 (OSA) 治疗结果. 这种组合疗法通过降低呼吸暂停-呼吸暂停指数 (AHI) 和增加口腔大侧壁崩患者的成功治疗反应率来提高HGNS的疗效.
科学领域:
- 睡眠医学 睡眠医学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术创新 在外科创新.
背景情况:
- 催眠神经刺激 (HGNS) 是阻塞性睡眠呼吸暂停 (OSA) 的有效治疗方法.
- HGNS的有效性可能受到口腔大侧壁 (OLW) 崩的限制.
- 桃体切除术与HGNS一起用于OSA患者的OLW崩的作用尚未确立.
研究的目的:
- 为了研究 palatine tonsillectomy 对 OSA 患有 OLW 崩的患者 HGNS 疗效的影响.
- 为了比较结合HGNS和桃体切除术 (HGNS+T) 与单独HGNS的结果.
主要方法:
- 进行了一项病例控制研究,对中度至重度的OSA患者进行了研究,这些患者表现出完全或部分OLW崩和小桃体.
- 同时接受 palatine tonsillectomy 和 HGNS (HGNS+T) 的患者与仅接受 HGNS 的对照组进行了比较.
- 用百分比减少呼吸暂停-呼吸暂停指数 (AHI) 和成功治疗反应来衡量疗效,并根据相关临床因素调整分析.
主要成果:
- 与单独使用HGNS (n=78) 相比,HGNS+T组 (n=19) 显示AHI额外减少了22.9%.
- 接受HGNS+T治疗的患者获得成功治疗反应的几率是8.6倍.
- 在HGNS+T组中,完全OLW崩的患病率更高,这表明即使在更复杂的情况下,疗效也更高.
结论:
- 将桃切除术与HGNS治疗结合起来似乎是一个有前途的策略,可以提高OLW崩的OSA患者的治疗成功率.
- 这种方法可以克服以前与HGNS相关的局限性,如果存在显著的口腔关阻塞.
- 早期的结果表明,与HGNS单独在这个患者群体中的历史结果相比,HGNS+T的疗效提高了.
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