Praneet C Kaki, Sophia N Shah, Julianna Rodin, Thomas M Kaffenberger, Maurits Boon, Colin Huntley
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引用次数: 0
Abstract
Objective: The apnea-hypopnea index (AHI) defines obstructive sleep apnea (OSA) severity but fails to describe nuances in disease burden. The modified sleep apnea severity index (mSASI) combines patient anatomy, weight, sleep study metrics, and symptoms to provide a composite OSA index ranging from 1 to 3. While prior studies have associated mSASI with quality of life and hypertension, its utility in continuous positive pressure intolerant (CPAPi) surgical patients remains unexplored.
Methods: A retrospective cohort study of surgically treated CPAPi patients who underwent upper airway stimulation (UAS), maxillomandibular advancement (MMA), or expansion sphincter pharyngoplasty (ESP) at our Tertiary Care Academic Center from 2014 to 2021. Five hundred twenty-eight patients were identified and 260 had available data to calculate mSASI pre- and postoperatively using the published method. Wilcoxon rank-sum tests were used during the analysis.
Results: Out of 260 patients, 167 underwent UAS (64%), 73 ESP (28%), and 20 MMA (8%). Fifty-five percent had a preoperative mSASI = 1 (average = 1.56, standard deviation = 0.68). The average overall change in mSASI postoperatively was -0.32 (p < .01). mSASI change in UAS, ESP, and MMA groups was -0.21, -0.51, and -0.50, respectively. Of note, 64% of UAS patients had a preoperative mSASI = 1, compared to 40% and 37% for MMA and ESP, respectively. The change in mSASI score was not significantly associated with treatment efficacy per Sher's Criteria (p = .6)Conclusion:The mSASI is a valuable alternative index to measure preoperative OSA severity and characterize surgical outcomes. Further prospective studies are needed to confirm these findings and to determine its ability to detect risk reduction post-treatment.
期刊介绍：
The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.
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