以懸壅垂腭皮瓣治療打鼾

Uvulopalatal Flap for Snoring

范振杰(Chen-Chieh Fan) ； 林堂烈(Tarng-Lieh Lin)

《台灣耳鼻喉頭頸外科雜誌》 38卷2期 (2003/04) Pp. 56-60

https://doi.org/10.6286/2003.38.2.56

摘要

背景：本研究嘗試以懸壅垂腭皮瓣來治療軟腭因素所致之打鼾及輕度阻塞性睡眠呼吸中止之病人，評估其療效、安全性及舒適性。
方法：自2001年3月開始，以打鼾為主訴至本院求診的病患，在接受詳細的病史記錄、整夜睡眠多項生理檢查、鼻咽纖維內視鏡檢查、到顱術等檢查後，篩選因軟腭因素導致打鼾及輕度睡眠呼吸中止之病人，依據個人意願選擇，以懸壅垂腭皮瓣之方式施行手術，評估其成效及併發症。
結果：自2001年5月至2001年9月，共施行手術13例，其中男性12名，女性1名。年齡平均40.8歲，體重質量指數平均26.1，呼吸干擾係數平均2.8，術後病患以問卷評估疼痛指數，術後第1天平均為3.8，術後第7天則為1.2。嗜睡指數術前平均6.8，術後平均2.2，分數明顯減少。打鼾指數術前平均7.9，術後平均4.7，亦有明顯改善，短期成功率為61%。在併發症方面，僅有1例發生皮瓣脫落之現象，並未發生腭咽閉鎖不全、術後出血或嚴重感染等情形。
結論：以懸壅垂腭皮瓣來治療打鼾為一安全且較不疼痛之方法，可避免腭咽閉鎖不全之併發症，為治療單純打鼾或輕度阻塞性睡眠呼吸中止症候群的一種選擇。

關鍵字

打鼾 ； 懸壅垂腭咽成形術 ； 懸壅垂腭皮瓣 ； 腭咽閉鎖不全

並列摘要

BACKGROUND: A new uvulopalatal flap (UPF) technique performed on patients with snoring and mild obstructive sleep apnea syndrome was evaluated for its efficacy, safety, and comfort.
METHODS: Between May and September 2001, patients presenting with a chief complaint of snoring underwent detailed history taking, overnight polysomnography and extensive airway evaluation. Subjects suffering simple snoring and mild obstructive sleep apnea with a soft palate as a contributing factor were selected and then consented to undergo a UPF procedure. Patient selection criteria were simple snoring or mild obstructive sleep apnea syndrome confirmed by polysomnography, respiratory disturbance index (RDI)＜20, and fiberoptic nasopharyngoscopy showing retropalatal region obstruction rather then base of tongue or lateral pharyngeal wall obstruction. Study variables included age, sex, body mass index, RDI, Epworth sleepiness scale (ESS), snoring score, and a visual analog score (VAS) of pain.
RESULTS: Twelve males and one female ranging in age from 27 to 52 years with a mean age of 40.8 years underwent the UPF procedure. Evaluation commenced in a prospective manner. Mean BMI was 26.1 and mean RDI was 2.8. The mean VAS of pain was 3.8 one day after surgery, and 1.2 one week after surgery. ESS and snoring scores before and after surgery showed a decrease from 6.8 to 2.2 for the ESS and a decrease from 7.9 to 4.8 for the snoring score. A minor complication of wound separation occurred in one case. The overall success rate in the study was 61 percent.
CONCLUSIONS: These early results suggest that the UPF procedure can reduce the risk of velopharyngeal insufficiency and is a safe and comfortable alternative for the treatment of snoring.

並列關鍵字

snoring ； uvulopalatopharyngoplasty UPPP ； uvulopalatal flap UPF ； velopharyngeal insufficiency VPI