Reasonable Risk Ratio of Palate Surgery: A New Critical Analysis.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Journal of Otolaryngology - Head & Neck Surgery Pub Date : 2024-01-01 DOI:10.1177/19160216241279074

Kenny P Pang,Joon Wei Lim,Kathleen A Pang,Claudio Vicini,Filippo Montevecchi,Ryan C T Cheong,Edward B Pang,Jin Keat Siow,Yiong Huak Chan,Brian Rotenberg

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引用次数: 0

Abstract

OBJECTIVE. A new critical complication risk analysis, the reasonable risk ratio (RRR or R3) for palate surgeries in obstructive sleep apnea patients. METHODS. Analysis from published meta-analyses, systematic reviews on success rates, and complications encountered for 3 palate surgeries, expansion sphincter pharyngoplasty (ESP), barbed repositioning pharyngoplasty (BRP) and modified uvulopalatopharyngoplasty (mUPPP), over 20 years. The RRR is derived from a ratio of the percentage of each respective complication over the success rate of that particular surgical procedure. The benchmark RRR of tonsillectomy is set at 0.035 to 0.078. An RRR below this benchmark value is more favorable as tonsillectomy is a widely accepted ENT procedure with risks to benefit well accepted. RESULTS. The RRR for foreign body (FB) sensation (BRP) ranged from 0.03 to 0.23 (mean RRR of 0.14), FB sensation (ESP) 0.01, FB sensation (mUPPP) ranged from 0.33 to 0.55 (mean RRR of 0.44). The RRR for swallowing difficulties (BRP) ranged from 0.04 to 0.23 (mean RRR of 0.11), mUPPP, was 0.37; no reported swallowing difficulties with the ESP. The RRR for velopharyngeal insufficiency (VPI) (BRP) ranged from 0.009 to 0.18 (mean RRR of 0.07), and RRR VPI (mUPPP) was 0.14. The RRR (BRP) for dry throat was 0.06 and the mUPPP was 0.35, with no reported VPI or dry throat for ESP. The overall RRR for the BRP was 0.09, ESP was 0.01 and mUPPP was 0.29. CONCLUSION. RRR provides a summarized data-driven, statistical guide to aid decision-making, and helps in patient counseling. BRP and ESP have been shown to have less complications compared to mUPPP.Level of evidence: IV.

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腭裂手术的合理风险比：新的批判性分析

目的：对阻塞性睡眠呼吸暂停患者的腭手术进行新的关键并发症风险分析，即合理风险比（RRR 或 R3）。方法：分析已发表的荟萃分析和系统综述，了解 20 年来 3 种腭手术（扩张括约肌咽成形术 (ESP)、带刺复位咽成形术 (BRP) 和改良悬雍垂腭咽成形术 (mUPPP)）的成功率和并发症情况。RRR 是根据每种并发症的发生率与该手术成功率的比率得出的。扁桃体切除术的基准 RRR 定为 0.035 至 0.078。结果发现，异物感（BRP）的成功率从 0.03 到 0.23 不等（平均成功率为 0.14），异物感（ESP）的成功率为 0.01，异物感（mUPPP）的成功率从 0.33 到 0.55 不等（平均成功率为 0.44）。吞咽困难（BRP）的 RRR 为 0.04 至 0.23（平均 RRR 为 0.11），mUPPP 为 0.37；没有报告 ESP 有吞咽困难。包咽不全（VPI）（BRP）的相关比率为 0.009 至 0.18（平均相关比率为 0.07），包咽不全（VPI）（mUPPP）的相关比率为 0.14。咽干的 RRR（BRP）为 0.06，mUPPP 为 0.35，没有关于 ESP VPI 或咽干的报告。BRP、ESP 和 mUPPP 的总RR 分别为 0.09、0.01 和 0.29。与 mUPPP 相比，BRP 和 ESP 的并发症更少：证据等级：IV。

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来源期刊

Journal of Otolaryngology - Head & Neck Surgery 医学-耳鼻喉科学

CiteScore

6.50

自引率

2.90%

发文量

审稿时长

6 weeks

期刊介绍： Journal of Otolaryngology-Head & Neck Surgery is an open access, peer-reviewed journal publishing on all aspects and sub-specialties of otolaryngology-head & neck surgery, including pediatric and geriatric otolaryngology, rhinology & anterior skull base surgery, otology/neurotology, facial plastic & reconstructive surgery, head & neck oncology, and maxillofacial rehabilitation, as well as a broad range of related topics.