Obstruktif Uyku Apnesi Sendromu (OUAS) Tedavisinde Kullanılan Sfinkter Faringoplasti Cerrahisinin Faringometri ve Polisomnografi ile Değerlendirilmesi

Abstract

The Evaluation of Expansion Sphincter Pharingoplasty Surgery Used in Obstructive Sleep Apnea Syndrome (OSAS) Treatment by Acoustic Pharyngometry and Polisomnography Obstructive sleep apnea syndrome (OSAS) is slightly common disease with a prevalance of 1-5%in the community, causing several serious cardiovascular morbidities and also impairs quality of life. Acoustic pharyngometry (AP)is non-invasive, cheap and easy to apply method, that gives objective numerical data and evaluates upper respiratory tract from the oral cavity to hypopharynx. Different anatomical structures defined along a graph and minimum and mean cross-sectional area and volume can be measured by these anatomic levels.Expansion sphincter pharyngoplasty (ESP) is a successful technique used for surgical treatment of OSAS. Clinical trial was conducted in OSAS diagnosed 35 patients. All patient were older than 18 years who had retropalatal obstruction and lateral pharyngeal wall collapse. The inclusion criteria included patients with small tonsils (tonsil size 1 and 2), body mass index (BMI) less than 35 kg/m2, and Friedman clinical stage II and III who cannot tolerate nasal continuous positive airway pressure (CPAP) therapy or for whom CPAP therapy failed. AP and polisomnography was performed preoperatively and postoperatively in third month in patients undergoing ESP. Thirty five patients were included. Success rate was calculated %62.9 when based on Sher criteria (postoperatively AHİ<20 and preoperativ AHI drop by at least 50%).Preoperative (preop) mean AHI of patients was 29,62±16.31, postoperative (postop) calculated as 18,25±18,1 (p <0,001). Preop mean minimum cross-sectional area (MCA) was 1,13±0,44 cm2,postop mean MCA measured as 2,26±0,39 cm2 (p<0,001). Preop MCA of successfully patients after surgery was (1,18±0,46) whereas preop MCA of unsuccessfully was (1,06 ±0,4) and the difference was not significant (p=0,517).There was no correlation between changes in Apnea hipopnea index, changes in minim cross-sectinal area and changes in pharyngeal volume (r =0.091). AF is not suitable for predicting surgical success after ESP surgery and for selection of patients who will be successful.