Posterior pillar hypertrophy as a novel anatomical predictor of surgical success in obstructive sleep apnea.

IF 3.4 3区医学 Q1 OTORHINOLARYNGOLOGY

Clinical and Experimental Otorhinolaryngology Pub Date : 2025-10-22 DOI:10.21053/ceo.2025-00200

Yeonsu Jeong, Jeong Jin Park, Min-Seok Rha, Hyung-Ju Cho

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引用次数: 0

Abstract

Objectives.: Sleep apnea surgery is effective only for selecting patients, making it crucial to identify those who will benefit. This study aimed to introduce a novel anatomical index for selecting patients with favorable surgical outcomes.

Methods.: A retrospective review was conducted on patients with obstructive sleep apnea who underwent multilevel surgery by a single surgeon at a tertiary medical institution between 2012 and 2021. Anatomical parameters, endoscopic images, and pre- and postoperative polysomnography reports were analyzed. Some patients exhibited posterior pillar hypertrophy (PPH), where the palatopharyngeal muscle is thicker than normal. To assess the effects of PPH exclusively, patients were randomly selected and subjected to propensity matching.

Results.: Logistic regression analysis identified tonsil grade, body mass index, and posterior pillar thickness as significant predictors of surgical success. The success rates were significantly different between the PPH(+) and normal control PPH(-) groups, with 51.9% success in the PPH(+) group compared to 40.7% in the PPH(-) group. Additionally, the PPH(+) group showed a significant increase in the apnea-hypopnea index and oxygen desaturation index postoperatively.

Conclusion.: The presence of posterior pillar hypertrophy serves as an important anatomical predictor of surgical success in obstructive sleep apnea treatment. This index helps in choosing patients and planning surgeries, potentially enhancing treatment.

Results.:

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后柱肥大作为阻塞性睡眠呼吸暂停手术成功的一种新的解剖学预测指标。

目标。睡眠呼吸暂停手术仅对选定的患者有效，因此确定哪些患者将受益至关重要。方法：回顾性分析2012年至2021年在某三级医疗机构由一名外科医生行多节段手术的阻塞性睡眠呼吸暂停患者。解剖参数，内镜图像，以及术前和术后多导睡眠图报告进行分析。一些患者表现出后柱肥大（PPH），其中腭咽肌比正常人厚。为了专门评估PPH的效果，随机选择患者并进行倾向匹配。结果：Logistic回归分析发现扁桃体分级、体重指数和后柱厚度是手术成功的重要预测因素。PPH（+）组与正常对照PPH（-）组的成功率有显著差异，PPH（+）组的成功率为51.9%，而PPH（-）组的成功率为40.7%。此外，PPH（+）组术后呼吸暂停低通气指数和氧去饱和指数显著升高。结论：后柱肥大的存在是阻塞性睡眠呼吸暂停治疗手术成功的重要解剖学预测指标。该指数有助于选择患者和计划手术，潜在地提高治疗效果。

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

Clinical and Experimental Otorhinolaryngology 医学-耳鼻喉科学

CiteScore

4.90

自引率

6.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical and Experimental Otorhinolaryngology (Clin Exp Otorhinolaryngol, CEO) is an international peer-reviewed journal on recent developments in diagnosis and treatment of otorhinolaryngology-head and neck surgery and dedicated to the advancement of patient care in ear, nose, throat, head, and neck disorders. This journal publishes original articles relating to both clinical and basic researches, reviews, and clinical trials, encompassing the whole topics of otorhinolaryngology-head and neck surgery. CEO was first issued in 2008 and this journal is published in English four times (the last day of February, May, August, and November) per year by the Korean Society of Otorhinolaryngology-Head and Neck Surgery. The Journal aims at publishing evidence-based, scientifically written articles from different disciplines of otorhinolaryngology field. The readership contains clinical/basic research into current practice in otorhinolaryngology, audiology, speech pathology, head and neck oncology, plastic and reconstructive surgery. The readers are otolaryngologists, head and neck surgeons and oncologists, audiologists, and speech pathologists.