BibTex RIS Kaynak Göster

Ağır Obstrüktif Uyku Apne Sendromlu Hastalarda Obstrüktif Uyku Apne Sendromlu Hastalarda Tek AşamalıÇok Seviyeli Cerrahi

Yıl 2015, Cilt: 1 Sayı: 3, 150 - 156, 01.01.2015

Öz

Amaç: Çalışmanın amacı ağır obstrüktif uyku apne sendromlu OSAS hastalarda uvulofaringopalatoplasti UPPP ile kombine edilmiş modifi ye dil kökü askısını içeren tek aşamalı çok seviyeli üst hava yolu cerrahisinin etkinliğini araştırmaktır. Gereç ve Yöntemler: Bu prospektif olgu serisi apne–hipopne indeksi AHI >30 olan, orofarengeal ve/veya hipofarengeal obstrüksiyonu olan ve sürekli pozitif hava yolu basıncı – CPAP tedavisini reddeden toplam 50 OSAS hastasını içermektedir. Tüm hastalara preoperatif ve postoperatif altıncı ayda polisomnografi uygulandı. Preoperatif AHI’ de ≥%50 azalma ile birlikte

Kaynakça

  • Shizuku H, Hori Y, Uemura T, Nakagawa H, Matsuda K, Kalubi B, Takeda N. Combination of Bernouilli effect producing maneuver-induced pharyngeal narrowing rate with body mass index as predictive tool for obstructive sleep apnea syndrome. Acta Otolaryngol 2008;128:569- 73.
  • Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet 2014;383:736-47.
  • Holmdahl C, Schöllin IL, Alton M, Nilsson K. CPAP treatment in obstructive sleep apnoea: A randomised, controlled trial of follow-up with a focus on patient satisfaction. Sleep Med 2009;10:869-74.
  • Engleman HM, Wild MR. Improving CPAP use by patients with sleep apnoea/hypopnea syndrome (SAHS). Sleep Med Rev 2003;7:81-99.
  • Lin HC, Friedman M, Chang HW, Gurpinar B. The effi cacy of multilevel surgery of the upper airway in adults with obstructive sleep apnea/hypopnea syndrome. Laryngoscope 2008;118:902-8.
  • Friedman M, Ibrahim H, Joseph NJ. Staging of obstructive sleep apnea/hypopnea syndrome: A guide to appropriate treatment. Laryngoscope 2004;114:454-9.
  • The AASM manual for the scoring of sleep and associated events: Rules, terminology and technical specifi cations.Iber C, Ancoli-Israel S, Chesson A, Quan S, eds. Westchester, American Academy of Sleep Medicine, 2007.
  • Shin SH, Ye MK, Kim CG. Modifi ed uvulopalatophar- yngoplasty for the treatment of obstructive sleep apnea- hypopnea syndrome: Resection of the musculus uvulae. Otolaryngol Head Neck Surg 2009;140:924-9.
  • Omur M, Ozturan D, Elez F, Unver C, Derman S.Tongue base suspension combined with UPPP in severe OSA patients. Otolaryngol Head Neck Surg 2005;133:218-23.
  • Sher AE, Schechtman KB, Piccirillo JF. The effi cacy of surgical modifi cations of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 1996;19:156-77.
  • Hessel NS, de Vries N. Diagnostic work-up of socially unacceptable snoring. II. Sleep endoscopy. Eur Arch Otorhinolaryngol 2002; 259:158-61.
  • van den Broek E, Richard W, van Tinteren H, de Vries N. UPPP combined with radiofrequency thermotherapy of the tongue base for the treatment of obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 2008;265:1361-5.
  • Eun YG, Kim SW, Kwon KH, Byun JY, Lee KH. Single-session radiofrequency tongue base reduction combined with uvulopalatopharyngoplasty for obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 2008;265:1495-500.
  • Richard W, Kox D, den Herder C, van Tinteren H, de Vries N. One stage multilevel surgery (uvulopalatopharyngoplasty, hyoid suspension, radiofrequent ablation of the tongue base with/without genioglossus advancement), in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 2007;264:439-44.
  • Robinson S, Chia M, Carney AS, Chawla S, Harris P, Esterman A. Upper airway reconstructive surgery long- term quality-of-life outcomes compared with CPAP for adult obstructive sleep apnea. Otolaryngol Head Neck Surg 2009;14:257-63.
  • Sun X, Yi H, Cao Z, Yin S. Reorganization of sleep architecture after surgery for OSAHS. Acta Otolaryngol 2008;128:1242-7.

Single-Stage Multilevel Upper Airway Surgery in Patients with Severe Obstructive Sleep Apnea Syndrome

Yıl 2015, Cilt: 1 Sayı: 3, 150 - 156, 01.01.2015

Öz

Objective: The aim of this study was to investigate the effi cacy of single–stage multilevel upper airway surgery including modifi ed tongue base suspension mTBS combined with uvulopharyngopalatoplasty UPPP in patients with severe obstructive sleep apnea syndrome OSAS .Material and Methods: This prospective case series includes a total of 50 OSAS patients who had an apnea–hypopnea index AHI >30 with oropharyngeal and/or hypopharyngeal obstruction, and rejected continuous positive airway pressure CPAP therapy. Polysomnography was performed in all subjects preoperatively and at the sixth postoperative month. The surgery was considered to be successful when a ≥50% reduction was obtained in the preoperative AHI and a postoperative AHI of 70 , santral uyku apne sendromu ve postoperatif dönemde kontrol polisomnografi sinin olmaması nedeniyle toplam 10 hasta çalışma dışı bırakıldı. Sonuç olarak 50 hastadan elde edilen veriler prospektif olarak analiz edildi.Tanısal UygulamalarPatients were stratifi ed into two groups according to their surgical outcome successful/unsuccessful , and the main preoperative and postoperative oxygenization parameters were compared again. There were statistically signifi cant improvements in all oxymetric values in patients in the successful group P

Kaynakça

  • Shizuku H, Hori Y, Uemura T, Nakagawa H, Matsuda K, Kalubi B, Takeda N. Combination of Bernouilli effect producing maneuver-induced pharyngeal narrowing rate with body mass index as predictive tool for obstructive sleep apnea syndrome. Acta Otolaryngol 2008;128:569- 73.
  • Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet 2014;383:736-47.
  • Holmdahl C, Schöllin IL, Alton M, Nilsson K. CPAP treatment in obstructive sleep apnoea: A randomised, controlled trial of follow-up with a focus on patient satisfaction. Sleep Med 2009;10:869-74.
  • Engleman HM, Wild MR. Improving CPAP use by patients with sleep apnoea/hypopnea syndrome (SAHS). Sleep Med Rev 2003;7:81-99.
  • Lin HC, Friedman M, Chang HW, Gurpinar B. The effi cacy of multilevel surgery of the upper airway in adults with obstructive sleep apnea/hypopnea syndrome. Laryngoscope 2008;118:902-8.
  • Friedman M, Ibrahim H, Joseph NJ. Staging of obstructive sleep apnea/hypopnea syndrome: A guide to appropriate treatment. Laryngoscope 2004;114:454-9.
  • The AASM manual for the scoring of sleep and associated events: Rules, terminology and technical specifi cations.Iber C, Ancoli-Israel S, Chesson A, Quan S, eds. Westchester, American Academy of Sleep Medicine, 2007.
  • Shin SH, Ye MK, Kim CG. Modifi ed uvulopalatophar- yngoplasty for the treatment of obstructive sleep apnea- hypopnea syndrome: Resection of the musculus uvulae. Otolaryngol Head Neck Surg 2009;140:924-9.
  • Omur M, Ozturan D, Elez F, Unver C, Derman S.Tongue base suspension combined with UPPP in severe OSA patients. Otolaryngol Head Neck Surg 2005;133:218-23.
  • Sher AE, Schechtman KB, Piccirillo JF. The effi cacy of surgical modifi cations of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 1996;19:156-77.
  • Hessel NS, de Vries N. Diagnostic work-up of socially unacceptable snoring. II. Sleep endoscopy. Eur Arch Otorhinolaryngol 2002; 259:158-61.
  • van den Broek E, Richard W, van Tinteren H, de Vries N. UPPP combined with radiofrequency thermotherapy of the tongue base for the treatment of obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 2008;265:1361-5.
  • Eun YG, Kim SW, Kwon KH, Byun JY, Lee KH. Single-session radiofrequency tongue base reduction combined with uvulopalatopharyngoplasty for obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 2008;265:1495-500.
  • Richard W, Kox D, den Herder C, van Tinteren H, de Vries N. One stage multilevel surgery (uvulopalatopharyngoplasty, hyoid suspension, radiofrequent ablation of the tongue base with/without genioglossus advancement), in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 2007;264:439-44.
  • Robinson S, Chia M, Carney AS, Chawla S, Harris P, Esterman A. Upper airway reconstructive surgery long- term quality-of-life outcomes compared with CPAP for adult obstructive sleep apnea. Otolaryngol Head Neck Surg 2009;14:257-63.
  • Sun X, Yi H, Cao Z, Yin S. Reorganization of sleep architecture after surgery for OSAHS. Acta Otolaryngol 2008;128:1242-7.
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makalesi
Yazarlar

Aslı Bostancı Bu kişi benim

Murat Turhan Bu kişi benim

Yayımlanma Tarihi 1 Ocak 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 1 Sayı: 3

Kaynak Göster

APA Bostancı, A., & Turhan, M. (2015). Ağır Obstrüktif Uyku Apne Sendromlu Hastalarda Obstrüktif Uyku Apne Sendromlu Hastalarda Tek AşamalıÇok Seviyeli Cerrahi. Akdeniz Tıp Dergisi, 1(3), 150-156.