Radiofrequency Coblation Inferior Turbinoplasty with Modified UPPP for the Treatment of Obstructive Sleep Apnea-Hypopnea Syndrome.

Qiushi Tian, Teng Chu, Mingjie Pang
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Abstract

Objective: To compare the efficacy of surgical treatment in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) involving a standalone modified uvulopalatopharyngoplasty (mUPPP) and radiofrequency coblation inferior turbinoplasty with mUPPP. Methods: In this study, a retrospective analysis of 79 OSAHS patients with inferior turbinate hypertrophy and oropharyngeal obstruction undergoing surgical treatment was performed. According to the different surgical methods, the patients were divided into 2 groups (Group A and Group B). Group A included 36 patients treated with standalone mUPPP. Group B included 43 patients treated with mUPPP and bilateral radiofrequency coblation inferior turbinoplasty. Polysomnography (PSG), active anterior rhinomanometry, surgical success rate, and surgical complication were used to assess the patients in 2 groups. The successful surgical result was defined as a 50% or greater decrease in the apnea-hypopnea index (AHI) in postoperative PSG. Results: Before surgery, there were no significant differences in age, gender, neck circumference, body mass index, Friedman tongue position grade, tonsil size grade, Epworth sleepiness scale score, total inferior turbinate size grade, total nasal resistance (TNR), AHI and the lowest O2 saturation (LSaO2) between the 2 groups. After 6 months of follow-up visits, AHI, LSaO2, and TNR in Group B showed a significant improvement compared to Group A. The surgical success rate was 76.74% in Group B compared to 52.78% in Group A (P = .025). There was no significant difference in the total surgical complication rate between the 2 groups (13.89% vs 23.26%, P = .290). Conclusion: For OSAHS patients with inferior turbinate hypertrophy and oropharyngeal obstruction, radiofrequency coblation inferior turbinoplasty with mUPPP appears to be a more effective surgical method than mUPPP alone.

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改良UPPP射频消融下鼻甲成形术治疗阻塞性睡眠呼吸暂停低通气综合征。
目的:比较独立改良悬垂腭咽成形术(mUPPP)与射频消融下鼻甲成形术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效。方法:回顾性分析79例手术治疗的OSAHS下鼻甲肥大合并口咽梗阻患者的临床资料。根据手术方式的不同,将患者分为A组和B组。A组36例患者采用独立mUPPP治疗。B组43例患者行mUPPP和双侧射频消融下鼻甲成形术。采用多导睡眠图(PSG)、主动前鼻测压、手术成功率、手术并发症等指标对两组患者进行评估。手术成功的定义是术后PSG的呼吸暂停低通气指数(AHI)下降50%或以上。结果:术前,两组患者在年龄、性别、颈围、体重指数、Friedman舌位分级、扁桃体大小分级、Epworth嗜睡评分、总下鼻甲大小分级、总鼻阻力(TNR)、AHI、最低血氧饱和度(LSaO2)等方面比较,差异均无统计学意义。随访6个月后,B组AHI、LSaO2、TNR均较a组有明显改善,手术成功率为76.74%,a组为52.78% (P = 0.025)。两组手术总并发症发生率比较,差异无统计学意义(13.89% vs 23.26%, P = 0.290)。结论:对于伴有下鼻甲肥大和口咽梗阻的OSAHS患者,射频消融下鼻甲成形术联合mUPPP比单纯使用mUPPP更有效。
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