Shu-Hua Li1, Da-Hai Wu2, Ji-Min Bao3, Hong-Jin Shi2. 1. Department of Otolaryngology-Head and Neck Surgery, General Hospital of Shenyang Military Area Command, Shenyang, Liaoning 110840, China. Email: lishsy@sina.com. 2. Department of Otolaryngology-Head and Neck Surgery, General Hospital of Shenyang Military Area Command, Shenyang, Liaoning 110840, China. 3. Department of Otolaryngology-head and Neck Surgery, Liaoning Jinqiu Hospital, Shenyang, Liaoning 110016, China.
Abstract
BACKGROUND: The most common obstruction sites for obstructive sleep apnea hypopnea syndrome (OSAHS) are the oropharynx and the glossopharyx. The diagnosis of glossopharyngeal airway obstruction is difficult. The study aimed to assess the effect of upper airway reconstructive surgery for OSAHS based on polysomnography (PSG) after nasopharyngeal tube insertion (NPT-PSG), and to evaluate the clinical value of NPT-PSG in localizing the obstructive sites. METHODS: Seventy-nine OSAHS patients diagnosed with PSG were included in the study. PSG was repeated with a nasopharyngeal tube in place (NPT-PSG). RESULTS: of the two PSGs were compared. A NPT-PSG apnea hypopnea index (AHI) greater than 15 times per hour was used as a threshold for glossopharyngeal surgery. The cause of glossopharyngeal airway obstruction was taken into consideration in planning glossopharyngeal surgery. Assessment of efficacy was followed-up. RESULTS: After NPT-PSG, patients' AHI significantly decreased and lowest oxygen saturation (LaSO2) significantly increased. Of the 79 patients, 47 were treated with uvulopalatopharyngoplasty (UPPP) alone and 32 with UPPP + glossopharyngeal surgery. Thirty-two patients were considered cured, 33 markedly improved, and 14 failed. The overall surgery success rate was 82.3%. CONCLUSIONS: NPT-PSG can be used as a diagnosis tool for localizing airway obstruction in OSAHS patients. Surgical treatment based on NPT-PSG results in good treatment efficacy.
BACKGROUND: The most common obstruction sites for obstructive sleep apnea hypopnea syndrome (OSAHS) are the oropharynx and the glossopharyx. The diagnosis of glossopharyngeal airway obstruction is difficult. The study aimed to assess the effect of upper airway reconstructive surgery for OSAHS based on polysomnography (PSG) after nasopharyngeal tube insertion (NPT-PSG), and to evaluate the clinical value of NPT-PSG in localizing the obstructive sites. METHODS: Seventy-nine OSAHS patients diagnosed with PSG were included in the study. PSG was repeated with a nasopharyngeal tube in place (NPT-PSG). RESULTS: of the two PSGs were compared. A NPT-PSG apnea hypopnea index (AHI) greater than 15 times per hour was used as a threshold for glossopharyngeal surgery. The cause of glossopharyngeal airway obstruction was taken into consideration in planning glossopharyngeal surgery. Assessment of efficacy was followed-up. RESULTS: After NPT-PSG, patients' AHI significantly decreased and lowest oxygen saturation (LaSO2) significantly increased. Of the 79 patients, 47 were treated with uvulopalatopharyngoplasty (UPPP) alone and 32 with UPPP + glossopharyngeal surgery. Thirty-two patients were considered cured, 33 markedly improved, and 14 failed. The overall surgery success rate was 82.3%. CONCLUSIONS: NPT-PSG can be used as a diagnosis tool for localizing airway obstruction in OSAHS patients. Surgical treatment based on NPT-PSG results in good treatment efficacy.