Evaluation of multiple plane operations in the treatment of severe obstructive sleep apnea hypopnea syndrome

Abstract

Abstract: PURPOSE：To evaluate the effect of multiple plane operations in the treatment of severe obstructive sleep apnea-hypopnea syndrome (OSAHS) and introduce the clinical experience of improving curative effect and reducing recurrence. METHODS: The clinical data of 21 patients with severe OSAHS were retrospectively analyzed. The 21 cases had definite diagnosis by X-ray cephalometry, nasopharyngeal fiberscope, PSG and clinical examination before operation. Preoperative PSG monitoring showed AHI was 58.8-74.0 (mean 67.8), the minimum SaO₂ was 0.25-0.67 (mean 0.46). LOSAT was 52-77 s (mean 63.3 s). All patients underwent two planes operations or more in the same term as below: modification of nasal septum deviation, partial middle turbinectomy and inferior turbinectomy, functional ethmoidectomy or maxillary sinus cystectomy with nasal endoscope, UPPP, tonsillectomy and GAHM. All patients underwent PSG examination and 15 cases were treated by nCPAP before operation. RESULTS: The patients were followed up for 8-68 months, twenty-one cases achieved primary healing and had no waking at night due to suffocating. Clinical symptoms disappeared or relieved markedly. Sleep snoring disappeared in 8 cases, while 13 cases still had slight or moderate snoring. Postoperative PSG monitoring showed AHI was 10.2 -24.2 (mean 20.3), the minimum SaO₂ was 0.82-0.99 (mean 0.91), LOSAT was 11 s- 35 s (mean 17.9 s). CONCLUSIONS: Severe OSAHS with multi-level obstructions in upper airway caliber, such as nasal nasopharyngeal, velo-pharyngeal and tongue-pharyngeal obstruction can be treated by multiple plane operations simultaneously, which can improve the outcome and shorten the treatment course.

Key words: OSAHS, Multiple plane operation, UPPP

CLC Number:

R782.2

LIU Zhong-yin, ZHANG Zong-de, TANG Xiao-yu, ZHAO Hao, FENG Xiao-dong, FU Sen-bo. Evaluation of multiple plane operations in the treatment of severe obstructive sleep apnea hypopnea syndrome[J]. China Journal of Oral and Maxillofacial Surgery, 2015, 13(1): 63-67.

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