Cho, Kyu-Sup; Koo, Soo-Kweon; Lee, Jong-Kil; Hong, Sung-Lyong; Capasso, Robson; Roh, Hwan-Jung
Auris, nasus, larynx
2014Dec ; 41 ( 6 ) :558-62.
PMID : 24862295
ÀúÀÚ »ó¼¼Á¤º¸
Cho, Kyu-Sup - Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Busan, South Korea.
Koo, Soo-Kweon - Department of Otorhinolaryngology, Busan St. Mary's Medical Center, Busan, South Korea.
Lee, Jong-Kil - Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Busan, South Korea.
Hong, Sung-Lyong - Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Busan, South Korea.
Capasso, Robson - Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, CA, USA.
Roh, Hwan-Jung - Department of Otorhinolaryngology and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea. Electronic address rohhj@pusan.ac.kr.
ABSTRACT
OBJECTIVE: The ideal palatal surgery for obstructive sleep apnea (OSA) and snoring must maintain the airway patency and correct anatomic abnormalities without complications. The purpose of this study was to investigate the efficacy of limited palatal muscle resection (LPMR) to improve OSA severity. SUBJECTS AND
METHODS: Twenty-three patients with OSA underwent LPMR. The LPMR was initiated with a bilateral tonsillectomy in patients with tonsil size 2 and 3. The LPMR consisted of partial resection of palatal muscles (levator veli palatini, palatoglossus, and musculus uvulae) with preservation of the uvula and a simple double layer suturing. The retropalatal space and the length of soft palate were evaluated by magnetic resonance imaging. Subjective outcomes using visual analog scales, Epworth Sleepiness Scale, and overnight polysomnography (PSG) data were assessed.
RESULTS: Six months after the operation, there was significant symptomatic improvement in snoring, morning headaches, tiredness, and daytime sleepiness. Postoperative magnetic resonance images showed upward and forward movement of uvula and soft palate after LPMR. The length of the soft palate was significantly shortened and the retropalatal space was significantly increased. Postoperative PSG revealed significant improvement in apnea-hypopnea index (AHI) and the total sleep time spent with oxygen saturation below 90%, and reduction in AHI following PMR was found in all patients. Furthermore, no patient experienced velopharyngeal insufficiency, voice changes, and pharyngeal dryness at 6 months follow-up.
CONCLUSIONS: The LPMR obtained significant improvement in subjective and objective outcomes in OSA, with preserved pharyngeal function. PMR is an effective and safe technique to treat oropharyngeal obstruction in OSA surgery. CI - Copyright ??2014 Elsevier Ireland Ltd. All rights reserved.
keyword
Muscles; Obstructive sleep apnea; Operative surgical procedures; Snoring; Soft palate
MESH
Adult, Cohort Studies, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Palatal Muscles/pathology/*surgery, Palate, Soft/pathology/*surgery, Pharynx/*surgery, Polysomnography, Sleep Apnea, Obstructive/*surgery, Tonsillectomy/*methods, Treatment Outcome, Young Adult
¸µÅ©