|
1
|
Li HY, Tsai MS, Lee LA, Hsin LJ, Lee YC, Lin WN, Lu YA, Shen SC, Cheng WN, Chaing YT. Palatal hybrid surgery for obstructive sleep apnea-state-of-the-art annotation of uvulopalatopharyngoplasty. Biomed J 2022; 46:100568. [PMID: 36356890 DOI: 10.1016/j.bj.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/16/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Surgery for obstructive sleep apnea (OSA) has changed in concept and technique that transformed from radical excision to functional reconstruction. The aim of this study was to investigate the safety and effectiveness of palatal hybrid surgery in OSA patients. METHODS Palatal hybrid surgery is a tissue-specific technique (mucosa-preservation, tonsil-excision, fat-ablation, muscle-relocation/suspension) used in treating OSA patients with velopharyngeal obstruction. The study included 46 consecutive adults OSA patients. The palatal hybrid surgery annotates uvulopalatopharyngoplasty in stereoscopic reconstruction of tonsillar fossa (pharyngoplasty), omni-suspension of the soft palate (palatoplasty) and advancement of uvula (uvuloplasty). RESULTS No patient experienced airway compromise, voice change or persistent nasal regurgitation following palatal hybrid surgery. One patient existed postoperative tonsillar fossa bleeding received conservative treatment. Postoperative pain in visual analogue scale (VAS) showed average score of 3, 3, 2, 0 at the 1st, 3rd, 7th, 14th day, respectively. Perioperative snoring severity (VAS) (8.7 vs 2.6) and daytime sleepiness (Epworth Sleepiness Scale) (11.3 vs 5.5) all improved significantly (p < 0.001). Posterior air space in retropalatal area increased from 8.4 to 11.1 mm (p < 0.001). Home sleep test showed that apnea-hypopnea index significantly reduced from 41.8 to 18.2 event/h and minimal oxygen saturation increased from 72.4 to 81.5% (p < 0.001). The success rate in individual Friedman stage was 100% (stage I), 63% (stage II) and 58% (stage III) with a total success rate of 63%. CONCLUSION Palatal hybrid surgery using tissue-specific maneuver annotates UPPP in concept and technique. The results show that palatal hybrid surgery is mini-invasive with low morbid and is effective in improving subjective clinic symptoms, objective sleep parameters and success rate of OSA.
Collapse
Affiliation(s)
- Hsueh-Yu Li
- Department of Otorhinolaryngology - Head and Neck Surgery, Sleep Center, -Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Ming-Shao Tsai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Departments of Otolaryngology - Head & Neck Surgery, Chang Gung Memorial Hospital at Chayi, Chayi, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Li-Ang Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Sleep Center, -Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Jen Hsin
- Department of Otorhinolaryngology - Head and Neck Surgery, Sleep Center, -Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Departments of Otolaryngology - Head & Neck Surgery, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Wan-Ni Lin
- Department of Otorhinolaryngology - Head and Neck Surgery, Sleep Center, -Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-An Lu
- Department of Otorhinolaryngology - Head and Neck Surgery, Sleep Center, -Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Chieh Shen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Departments of Otolaryngology - Head & Neck Surgery, New Taipei City Municipal Tucheng Hospital, New Taipei, Taiwan
| | - Wen-Nuan Cheng
- Department of Sports Sciences, University of Taipei, Taipei, Taiwan
| | - Yen-Ting Chaing
- Department of Otorhinolaryngology - Head and Neck Surgery, Sleep Center, -Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan
| |
Collapse
|