Modified-coblation assisted UPPP in treatment of severe obstructive sleep apnea-hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore a new way to modify the UPPP and to assess the operative efficacy of modified-coblation assisted UPPP (M-CAUP) on patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS).@*METHOD@#A retrospective analysis was made on surgical therapeutic effect of M-CAUP performed in our hospital.@*INCLUSION CRITERIA@#87 adult inpatients with severe OSAHS were involved in the study whose preoperative AHI were beyond 30/h and LSaO2 were under or equal to 85%. All those had the primary level obstruction within the retropalatal region as determined by PSG and airway pressure fluctuation monitoring (ApneaGraph 200, MRA-Medical Ltd, Gloucestershire UK) . The surgical approach of M-CAUP: (1) bilateral tonsillectomy by using Arthrocare EVac 70 T&A Wand. (2) dissection of velum palatinum space by using Arthrocare EVac 70 T&A Wand, ablation of fat tissue to removed it from the space, avoiding injure levator palatini muscle and tensor palatini muscle and preserving musculus uvula, maintaining the normal structure of oropharynx. (3) ablation of channel of soft palate by using Arthrocare EVac 55 T&A Wand to reduce the volume of soft palate moderately. (4) plasty: suturing the tonsilar fossa to close the space, interrupted suture two sides of palatine arch and uvula. All patients were followed up for six to eighteen months postoperatively and received PSG.@*RESULT@#After M-CAUP, the pharyngeal cavity was enlarged while the basic structure of oropharynx was maintained and no nasopharyngeal refluxing occurred. The subjective symptoms were also improved evidently after operation. After operation, the AHI and Epworth sleepiness scale (ESS) decreased while LSaO2 increased. The reduction of AHI and ESS had statistical significance (P < 0.01), and the rise of LSaO2 also had statistical significance (P < 0.01). The total effective ratio of the operation was 89.7%.@*CONCLUSION@#Despite of various treatment, the operative efficacy of conventional UPPP was almost not ideal on severe OSAHS due to complex pathogeny. It was proved that M-CAUP was an effective surgical treatment of severe OSAHS with less blood loss. The operation was minimally invasive and maintained the normal functions of palatopharynx in principle. It could be applied in clinical practice.

Plasma radiofrequency ablation in treatment of recurrence of adenoidal hypertrophy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the long-term outcome and clinical value of utilizing plasma radio frequency ablation under indirect laryngoscope in treatment of recurrence of adenoidal hypertrophy.@*METHOD@#Fifty patients with recurrence of adenoidal hypertrophy were subjected to the operation designed by our group.@*RESULT@#The period of follow-up was more then 2 years. All patients were free of snore postoperatively; conductive hearing loss was improved as well.@*CONCLUSION@#Operation with plasma radiofrequency ablation had advantages of direct and clear view of surgical area, accurate remove of adenoids, non-bleeding, avoiding damage of normal nasopharyngeal structure structures, minimal invasion, high safety, and little complication, in treatment of recurrence of adenoidal hypertrophy.

Effect of plasma radiofrequency ablation on obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#It was aimed to investigate the effect of plasma radiofrequency ablation on obstructive sleep apnea hypopnea syndrome.@*METHOD@#Fifty-four patients with OSAHS were treated with plasma radiofrequency ablation on soft palate, tonsil, uvula and root of tongue in light of needs.@*RESULT@#All these cases were reevaluated with PSG by the end of postoperative period lasted for three month. Among them, 6 were cured, 24 had significant therapeutic effect, 19 had effective outcome, and 5 had no effective, with a total effective rate of 90.74%. No serious complications occurred.@*CONCLUSION@#This method was safe and effective, and patients had mild lesion, less bleeding, less painful and the advantages of simple operation.