Effects of Soft Tissue Sleep Surgery on Morbidly Obese Patients.
| Autor: | Shaikh N; Otolaryngology Department, West Virginia University, Morgantown, WV, USA., Tumlin P; Otolaryngology Department, West Virginia University, Morgantown, WV, USA., Greathouse Z; West Virginia University School of Medicine, Morgantown, WV, USA., Bulbul MG; Otolaryngology Department, West Virginia University, Morgantown, WV, USA., Coutras SW; Otolaryngology Department, West Virginia University, Morgantown, WV, USA. |
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| Jazyk: | angličtina |
| Zdroj: | The Annals of otology, rhinology, and laryngology [Ann Otol Rhinol Laryngol] 2023 Feb; Vol. 132 (2), pp. 138-147. Date of Electronic Publication: 2022 Feb 28. |
| DOI: | 10.1177/00034894221081098 |
| Abstrakt: | Introduction: Morbidly obese patients with obstructive sleep apnea (OSA) are often intolerant of continuous positive airway pressure (CPAP). The effects of sleep surgery in this population is not well documented, and sleep surgery is generally avoided due to the expectation of poor outcomes, leaving these patients untreated. Methods: This retrospective study included 42 patients with a body mass index (BMI) ≥40.0 and OSA with a preoperative apnea hypopnea index (AHI) ≥5. Preoperative BMI ranged from 40.0 to 69.0 kg/m 2 . Preoperative AHI ranged from 7.2 to 130.0. Of 42 patients, 12 (28.6%) underwent concurrent pharyngeal and retrolingual surgery. Subgroup analysis of change in AHI was measured with respect to preoperative OSA severity, change in preoperative BMI, and BMI severity. Univariate linear and logistic regression was performed assessing change in AHI and surgical success with respect to age, sex, preoperative AHI, preoperative BMI, change in BMI, total procedures, palatal procedure, retrolingual procedure, nasal procedure, and multilevel procedures. Results: The mean AHI improved from 45.9 ± 31.8 to 31.9 ± 31.6 ( P = .007). Epworth sleepiness score (ESS) improved from 13.2 ± 5.5 to 9.6 ± 5.4 ( P = .00006). Lowest oxygen saturation (LSAT) improved from 74.4 ± 10.7 to 79.9 ± 10.4 ( P = .002). About 33.3% of patients had surgical success (AHI < 20 with at least 50% reduction in AHI). Preoperative AHI was the most significant factor for change in AHI in univariate and multivariate models ( P = .015). Conclusion: Sleep surgery is effective in reducing OSA burden in most morbidly obese patients and can result in surgical cure for a third of patients. |
| Databáze: | MEDLINE |
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