Surgical Treatment of Patients with Severe Obstructive Sleep Apnea Syndrome
| Autor: | Wakako Kawanabe, Yasuhiro Chihara, Yoh-iehiro Maeda, Takashi Fukaya, Tsunehiro Saito, Yoshinori Fujishiro |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Otorhinolaryngologic Surgical Procedures Polysomnography medicine.medical_treatment Palatine Tonsil Severity of Illness Index stomatognathic system medicine Humans Continuous positive airway pressure Retrospective Studies Sleep Apnea Obstructive Continuous Positive Airway Pressure medicine.diagnostic_test business.industry Patient Selection Uvulopalatopharyngoplasty Retrospective cohort study medicine.disease nervous system diseases respiratory tract diseases Tonsillectomy Obstructive sleep apnea Treatment Outcome Otorhinolaryngology Apnea–hypopnea index Anesthesia Female business |
| Zdroj: | Nippon Jibiinkoka Gakkai Kaiho. 107:744-749 |
| ISSN: | 1883-0854 0030-6622 |
| DOI: | 10.3950/jibiinkoka.107.744 |
| Popis: | No standard indications currently exist for surgical treatment of severe obstructive sleep apnea syndrome (OSAS). We treated 15 patients with severe OSAS surgically, evaluated surgical indications, and evaluated surgical success. We retrospectively reviewed 15 cases of surgery for OSAS in which polysomnography met 2 or more criteria for the following surgical indications: (1) apnea hypopnea index (AHI) > or = 50, (2) minimum SpO2 below 80%, and (3) enlarged tonsils (grade III, Mackenzie's classification). Among the 15, mean AHI was 85.1. Surgery was done under general anesthesia, with uvulopalatopharyngoplasty (UPPP) in 13 and tonsillectomy alone in 2. Postoperative AHI was measured in 9 patients. According to Nishimura's criteria for assessing surgical success, improvement was "excellent" in 5, "good" in 1, "fair" in 1, and "poor" in 2. When we compared preoperative and postoperative use of continuous positive airway pressure (CPAP) in 7, we found that surgery decreased CPAP requirements. Surgical success was assessed in patients requiring CPAP and improvement was "excellent" in 5, "good" in 1, and "fair" in 1. In conclusion, surgical indications for severe OSAS, including the criterion of enlarged tonsils, were useful. Surgery decreased CPAP requirements and the degree of improvement in this requirement and AHI was valuable in assessing surgical success. |
| Databáze: | OpenAIRE |
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