Obstructive Sleep Apnea Syndrome - Effectivity of Different Surgical Approaches
Authors:
J. Betka; J. Klozar; M. Kuchař; J. Kastner; J. Plzák
Authors‘ workplace:
1. lékařská fakulta, Univerzita Karlova v Praze a Fakultní nemocnice v Motole, Praha
; Klinika otorinolaryngologie a chirurgie hlavy a krku
Published in:
Otorinolaryngol Foniatr, 63, 2014, No. 1, pp. 3-9.
Category:
Original Article
Overview
The aim of this retrospective study is to evaluate the effectivity of several surgical procedures for the treatment of obstructive sleep apnea syndrome (OSAS): bilateral tonsillectomy, uvulopalatopharyngoplasty (UPPP), uvulopalatopharyngoplasty combined with radiofrequency induced thermotherapy (RFITT) of the base of the tongue and UPPP + RFITT of the base of the tongue with septoplasty. The study included 133 patients, who underwent one-time surgical procedure. Basic criteria of success were changes in apnea-hypopnea index measured by whole night polygraphy before and 6 months after the surgery. Also the subjective benefit for the patient and the number of complications were measured. Based on previous criteria overall success of surgical treatment was 51%, patients with mild degree of OSAS achieved slightly better results. In comparison of different surgical methods the effectivity was 45-71% with better results of multilevel surgery than UPPP alone. 84% of patients described decrease of subjective disorders. Complication of surgery appeared at 4 patients.
Keywords:
rhonchopathy, obstructive sleep apnea syndrome, uvulopalatopharyngoplasty, radiofrequency thermotherapy
Sources
1. Crumley, R. I., Stein, S., Gansor, G., Golden, J., Dermon, S.: Determination of obstructive sites in obstructive sleep apnea. Laryngoscope, 97, 1987, s. 301-308.
2. Friedman, M.: Sleep endoscopy versus modified Mallampati score for OSA and snoring. Laryngoscope, 115, 2005, s. 2072-2073.
3. Hessel, N. S.: Snoring and obstructive sleep apnea syndrome: Diagnostic and therapeutic aspects: with special emphasis on UPPP, ABC Minimax Grafische Bedrijven B. V., 2004.
4. Hörmann, K., Verse, T.: Surgery for sleep disordered breathing, 2nd es., Springer Heidelberg, New York, 2005.
5. Klozar, J., Plzák, J., Zábrodský, M., Betka, J.: Effectivness and side effects of one-stage laser-assisted uvuloplasty in primary rhonchopathy. ORL. J. Otorhinolaryngol. Relat. Spec., 69, 2007, s. 316-321.
6. Klozar, J., Zábrodský, M., Plzák, J.: Chirurgická léčba chrápání a spánkového apnoického syndromu. Postgraduální medicína, 11, 2009, s. 43-47.
7. Larsson, L. H., Carlsson-Nordlander, B., Svanborg, E.: Four-year follow-up after uvulopalatopharyngoplasty in 50 unselected patients with obstructive sleep apnea syndrome. Laryngoscope, 104, 1994, s. 1362-1368.
8. Louble, D. I., Louble, A. A., Mitler, M. M.: Weight loss for obstructive sleep apnea: the optimal therapy for obese patients.J. Am. Diet. Assoc., 94, 1994, s. 1291-1295.
9. Martimore, I. L., Marshal, I.: Neck and total body fat deposition in non-obese and obese patients with sleep apnea compared with that in control studies. Am. J. Respir. Crit. Care. Med., 157, 1998; s. 280-283.
10. Maurer, J.: Surgical treatment of obstructive sleep apnea: Standard and emerging techniques. Current Opinion in Pulmonary Medicine, 16, 2010, s. 552–558.
11. Pirsing, W., Verse, T.: Long-term results in the treatment of obstructive sleep apnea. Eur. Arch. Otorhinolaryngol., 287, 2000, s. 570-577.
12. Plzák, J., Zábrodský, M., Kastner, J., Betka, Jar., Klozar, J.: Combined bipolar radiofrequency surgery of the tongue base and uvulopalatopharyngoplasty for obstructive sleep apnea. Archives of Medical Science, 2013, v tisku.
13. Plzák, J., Zábrodský, M., Kastner, J., Klozar, J., Betka, J.: Uvulopalatofaryngoplastika kombinovaná s radiofrekvenční termoterapií kořene jazyka v léčbě obstrukčního syndromu spánkové apnoe. Otorinolaryng a Foniat. /Prague/, 3, 2009, s. 140-143.
14. Pniak, T., Matoušek, P., Štrympl, P., Novák, V., Komí-nek, P.: Obstrukční spánková apnoe – význam septoplastiky a turbinoplastiky Část I (teoretická část). Otorinolaryng. a Foniat. /Prague/, 59, 2010, s. 180-185.
15. Pniak, T., Matoušek, P., Štrympl, P., Novák, V., Komí-nek, P.: Obstrukční spánková apnoe – význam septoplastiky a turbinoplastiky Část II (praktická část). Otorinolaryng. a Foniat./Prague/, 59, 2010, s. 186-189.
16. Pretl, M., Hobzová, M., Honnerová, M., Lněnička, J., No-vák, V., Sedlák, V., Vyskočilová, J., Šonka, K.: Indikační kritéria pro léčbu poruch dýchání ve spánku pomocí přetlaku v dýchacích cestách u dospělých. Česká společnost pro výzkum spánku a spánkovou medicínu, 11, 2011, http://www.sleep-society.cz/doporucenepostupy/.
17. Shepard, J. W. Jr.: Hypertension, cardiac arrythmias, myocardial infarction, and stroke in relation to obstructive sleep apnea. Clin. Chest. Med., 13, 1992, s. 437-458.
18. Sher, A. E., Schechtman, K. B., Piccirillo, J. F.: The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Slep, 19, 1996, s. 156-177.
19. Tan, L. T., Tan, A. K., Hsu, P. P., Loh, I. C., Yuen, H. W.,Chan, Y. H., Lu, P. K.: Effects of tonsillectomy on sleep study parameters in adult patients with obstructive sleep apnea-a prospective study. Sleep Breath, 2013 Jul 19, in press.
20. Verse, T., Bodlaj, R., de la Chaux, R.: Guideline: treatment of obstructive sleep apnea in adults (in German). HNO, 57, 2009, s. 1136-1156.
21. Vicini, C., Dallan, I., Campanini, A. et al.: Surgery vs. ventilation in adult severe obstructive sleep apnea syndrome. Am. J. Otolaryngol., 31, 2010, s. 14-20.
22. Vyskočilová, J.: Syndrom spánkové apnoe, doporučené postupy pro praktické lékaře. Česká lékařská společnost J. E. Purkyně, Reg. č. o/036/024, 2001, 6 s.
23. Weiss, J. W., Remsburg, S., Garpestad, E., Ringler, J., Sparrow, D., Parker, J. A.: Hemodynamic consequences of obstructive sleep apnea, Sleep, 19, 1996; s. 388-397.
24. Woodhead, C. J., Davies, J. E., Allen, M. B.: Obstructive sleep apnea in adults presenting with snoring. Clin. Otolaryngol., 16, 1991, s. 401-405
25. Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., Badr, S.: The occurrence of sleep-disordered breathing in middle-aged adults. N. Engl. J. Med., 328, 1993, s. 1230-1235.
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Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
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