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KMID : 0900220170240010020
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대한비과학회지
2017 Volume.24 No. 1 p.20 ~ p.25
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Study for Clinical Efficacy of Sleep Surgery in Treatment of Patients with Moderate-Severe Obstructive Sleep Apnea
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Lee Woo-Hyun
Oh Seung-Yong
Oh Hoon
Park Yong-Kyun
Min Sang-Gi
Shin Ji-Ho
Kim Hyun-Jik
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Abstract
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Background and Objectives: Surgical treatment is considered as a secondary treatment option for obstructive sleep apnea
(OSA). This study was performed to determine whether surgical treatment can be considered in patients with moderate-severe OSA as a treatment modality.
Materials and Method: A total of 127 patients with moderate-severe OSA were retrospectively enrolled. The anatomic narrowing sites were mainly evaluated using cephalometry and drug induced sleep endoscopy (DISE), and then multi-level surgeries were performed.
Results: Both uvula and soft palate were the most frequent narrowing sites and a total of 110 patients showed upper airway
narrowing more than two anatomic structures. A total of 79 patients (62.1%) were categorized as responders and 48 patients (39.1%) were non-responders. After multi-level sleep surgeries, patients’ subjective symptoms and sleep parameters were significantly improved. However, AHI was not considerably decreased. Non-responders to sleep surgeries showed relatively higher rates of severe OSA and body mass index. Tongue base narrowing, incomplete corrections of nasal pathologies and soft palate were significant factors for lower success rates.
Conclusion: We estimate that sleep surgery might be a therapeutic option for moderate to severe patients with OSA. A delicate pre-operative evaluation for upper airway narrowing is necessary to adapt sleep surgery to these patients.
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KEYWORD
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Obstructive sleep apnea, Sleep surgery, Drug induced sleep endoscopy, Severity, Efficacy
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