經口機械手臂治療睡眠呼吸中止症之術後味覺症狀追蹤

Gustatory Outcome After Transoral Robotic Surgery for Obstructive Sleep Apnea Syndrome

林敬涵(Jing-Han Lin) ； 蘇茂昌(Mao-Chang Su) ； 辛宗翰(Chung-Han Hsin) ； 曹傑漢(Chien-Han Tsao) ； 黃新心(Hsin-Hsin Huang) ； 溫惟昇(Wei-Sheng Wen)

《台灣耳鼻喉頭頸外科雜誌》 55卷1期 (2020/03) Pp. 9-16

https://doi.org/10.6286/jtohns.202003_55(1).009

摘要

背景：手術治療睡眠呼吸中止症中，經口機械手臂舌根縮減術在軟組織手術上的效益逐漸備受肯定。然而對於術後長短期之症狀，如吞嚥、味覺的變化等觀察，缺乏系統性文獻探討，這代表患者的手術後品質可以進一步闡明，故提出本院味覺觀察結果。本研究呈現經口機械手臂治療睡眠呼吸中止症術後長短期之主觀味覺變化結果。方法：15名睡眠呼吸中止症個案接受懸壅垂顎咽成形術與側咽成形術，並以經口機械手臂執行3 cm寬度舌根縮減術之後，蒐集該15名患者味覺變化數據。使用視覺輔助味覺評估量表，於術後2週、3週、4週、3個月、5個月及2年定期追蹤並評估甜味、酸味、苦味、鹹味、鮮味及幻味之主觀感覺，並分析味覺障礙的種類與持續時間。結果：術後5個月結果顯示，73.3%個案甜味、酸味恢復正常，68.8%個案苦味、鹹味恢復正常，53.3%個案鮮味恢復正常，無患者表示有幻味（金屬味）；術後2年結果顯示，93.3%個案甜味恢復正常，86.7%個案酸味、鹹味與鮮味恢復正常，無患者表示有苦味與幻味。結論：研究結果顯示經口機械手臂治療睡眠呼吸中止症，患者術後的長短期味覺異常須留意。

關鍵字

gustatory dysfunction ； obstructive sleep apnea syndrome ； transoral robotic surgery ； uvulopalatopharyngolplasty（味覺異常 ； 阻塞性睡眠呼吸中止症 ； 經口機械手臂手術 ； 懸壅垂咽顎成形術）

並列摘要

BACKGROUND: In the options of surgical treatment for sleep apnea syndrome, transoral robotic surgery (TORS) gradually became universal and showed its great performance in recent years. However, some postoperative changes in gustatory dysfunction are poorly understood and very few studies address this crucial problem. This indicates some more elucidation of gustatory outcomes for patients after surgery is as far as required. This study aimed to follow the gustatory outcome of patients with obstructive sleep apnea syndrome (OSAS) who underwent TORS in Chung Shang medical university hospital and to follow the short and long-term results of gustatory dysfunction. METHOD: This prospective study was carried out on fifteen patients who were diagnosed as OSAS and treated with uvulopalatopharyngoplasty with lateral pharyngoplasty and 3 cm wide tongue base volume reduction under transoral robotic surgery. Afterward, some questionnaires for subjects preoperatively and 2, 3, 4 weeks and 5 months and 2 years of follow-up data postoperatively. Taste assessment included a subjective sensation of sweet, sour, bitter, salty, umami, and metallic to detect qualitative gustatory disorder and traced the type and duration of gustatory dysfunction. RESULTS: After 5 months, 73% of the sweet taste and sour taste returned to normal, 68.8% of bitter and salty tastes returned to normal, and 53.3% of umami taste returned to normal. No patient expressed phentoguesia (metallic sensation). After two years, 93.3% of sweet taste recovered, 86.7% of sour, salty and umami tastes back to normal, and bitterness and phentoguesia were normal. CONCLUSIONS: This investigation demonstrated variable gustatory outcomes associated with taste among patients after TORS for OSAS. The short and long-term taste abnormality should be noted.

並列關鍵字

gustatory dysfunction ； obstructive sleep apnea syndrome ； transoral robotic surgery ； uvulopalatopharyngolplasty