Is it important to stabilize palatopharyngeus muscle to pterygomandibular raphe under vision during surgery for OSA?

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-09-13 DOI:10.1007/s00405-024-08924-2

Mohamed Salah Rashwan, Mohamed Abdelazem Khalafallah, Hoda Mahmoud Abdelsadek, Mahmoud Ahmed Hassan, Tarek Abdelzaher Emara

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Abstract

Purpose

Access the importance of visualizing the pterygomandibular raphae (PMR) while fixing palatopharyngeous (PPM) muscle to the pterygomandibular raphae (PMR).

Methods

Randomized controlled trial. First group, forty-two OSA patients performed either Anterolateral advancement pharyngoplasty (ALA) or Barbed reposition pharyngoplasty (BRP) while visualizing the PMR according to the following criteria: age between 21 and 60 years, body mass index (BMI) < 35, and patients with lateral pharyngeal collapse diagnosed with drug induced sleep endoscopy (DISE). The results were compared to the second control group of 42 patients performed the same procedures without exposing the PMR.

Results

PMR was bilaterally present in 27 (64.28%) patients and bilaterally absent in 5 (11.8%) patients while unilateral in 10 (23.9%) patients. PSG findings in group 1: Apnea hypopnea index (AHI) decreased from 40.84 ± 26.93 to 14.81 ± 7.43 (P < 0.001), mean Lowest oxygen saturation (LOS) significantly increased from 79.25 ± 14.93 to 89.92 ± 10.7 (P < 0.001) and Epworth sleepiness scale (ESS) significantly dropped from 13.25 ± 4.65 to 6.1 ± 2.06 (P < 0.001). Group 2 results showed AHI decrease from 27.50 ± 11.56 to 11.22 ± 7.63 (P ≤ 0.001), LOS increased from 81.86 ± 6.41 to 90.21 ± 3.70 and ESS dropped from 14.95 ± 3.72 to 7.91 ± 3.05. The difference between both groups was not statistically significant (P > 0.001).

Conclusion

Fixation of PPM to the PMR under direct vision doesn’t significantly affect the surgical outcomes but can increase the procedure efficiency and reduce complication rate keeping in mind that PMR may be absent in some patients.

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在 OSA 手术中，在视野下稳定腭咽肌与翼颌剑突是否重要？

目的了解在将腭咽（PPM）肌固定在翼颌耙（PMR）上的同时观察翼颌耙（PMR）的重要性。方法随机对照试验。第一组，42 名 OSA 患者，在观察 PMR 的同时，根据以下标准进行前外侧推进咽成形术（ALA）或倒钩复位咽成形术（BRP）：年龄在 21 岁至 60 岁之间，体重指数（BMI）为 35，经药物诱导睡眠内窥镜检查（DISE）确诊为咽外侧塌陷。结果27名患者（64.28%）双侧存在PMR，5名患者（11.8%）双侧不存在PMR，10名患者（23.9%）单侧存在PMR。第 1 组的 PSG 结果显示：呼吸暂停低通气指数（AHI）从 40.84 ± 26.93 降至 14.81 ± 7.43（P <；0.001），平均最低血氧饱和度（LOS）从 79.25 ± 14.93 显著升至 89.92 ± 10.7（P <；0.001），埃普沃思嗜睡量表（ESS）从 13.25 ± 4.65 显著降至 6.1 ± 2.06（P <；0.001）。第 2 组结果显示，AHI 从 27.50 ± 11.56 降至 11.22 ± 7.63（P ≤ 0.001），LOS 从 81.86 ± 6.41 升至 90.21 ± 3.70，ESS 从 14.95 ± 3.72 降至 7.91 ± 3.05。两组之间的差异无统计学意义（P >0.001）。结论在直视下将 PPM 固定在 PMR 上并不会对手术效果产生显著影响，但可以提高手术效率并降低并发症发生率，因为有些患者可能没有 PMR。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.