[耳鼻喉科睡眠呼吸暂停综合征的外科治疗]。

Sbornik lekarsky Pub Date : 2002-01-01
P Rambousek
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引用次数: 0

摘要

睡眠呼吸暂停综合征必须通过标准的一套或收集的检查来确切地确认。诊断是通过耳鼻喉科检查、polyMESAM夜间记录或完整的多导睡眠图来区分和确定的。然后行神经学和上颌骨检查,x光片(头颅测量资料)和咽CT检查。病人的一部分需要动手术。在腭咽间隙区域,我们进行了经典的uvulopalat咽成形术(UPPP),由Fujita 1981年在底特律首次描述[4]。这意味着,我们切除两个扁桃体然后切除部分软腭来扩大腭咽间隙。舌后梗阻和肥胖是UPPP成功的负面预测因素。后气道间隙狭窄是替代疗法的适应症,称为上颌下颌前进。我们倾向于不使用激光的传统手术方法。儿童群体因腺样体残留而行腺切开术,有时需加行扁桃体切除术以获得良好的术后效果。部分患者因局部发现鼻中隔梗阻或其他鼻腔或鼻咽部解剖异常而行鼻中隔成形术。由于CPAP治疗的原因,该手术非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Surgical treatment of sleep apnea syndrome in otorhinolaryngology].

Sleep apnea syndrome must be exactly confirmed by the standard set or collection of examinations from rhonchopathy. The diagnosis is distinguished and identify by ENT examination, nocturnal recording by polyMESAM or by complete polysomnography. Then is performed neurological and maxillomandibular examination, X-rays pictures (cephalometric data), and CT of pharynx. Part of patient is indicated to undergo surgery. In region of velopharyngeal space we performed classical uvulopalatopharyngoplasty (UPPP), described first time by Fujita 1981 in Detroit [4]. It means, that we take out both tonsils and then remove part of soft palate to enlarging the velopharyngeal space. The findings of retrobasilingual obstruction and obesity are negative predictors for success of UPPP. Narrowing of posterior airway space is indication for the alternative therapy called maxillomandibular advancement. We prefer the surgery by classical method without laser. Adenotomy is performed in children population since residuum of adenoids, and sometimes tonsillectomy should be added for good postoperative results. Part of patient should undergo septoplasty due to local findings of obstruction or another anatomical abnormalities on the level of nasal cavity or nasopharynx. This surgery is very important for this reason of treatment by CPAP.

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