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Contemporary Surgery for Obstructive Sleep Apnea Syndrome

Nelson B. Powell
대한이비인후과학회 (Korean Society of Otorhinolaryngology-Head and Neck Surgery)|2009.09|Clinical and Experimental Otorhinolaryngology|제2권 제3호|pp. 107-114

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참고문헌

키워드

Obstructive sleep apneaAirway reconstructionPowell-Riley protocolContemporary surgery

초록

Surgical treatment of obstructive sleep apnea syndrome (OSAS) has been available in some form for greater than three decades. Early management for airway obstruction during sleep relied on tracheotomy which although life saving was not well accepted by patients. In the early eighties two new forms of treatment for OSAS were developed. Surgically a technique described as a uvulopalatopharyngoplasty (UPPP) was used to treat the retropalatal region for snoring and sleep apnea. Concurrently sleep medicine developed a nasal continuous positive airway pressure (CPAP) device to manage nocturnal airway obstruction. Both of these measures were used to expand and stabilize the pharyngeal airway space during sleep. The goal for each technique was to limit or alleviate OSAS. Almost 30 yr later these two treatment modalities continue to be the mainstay of contemporary treatment. As expected, CPAP device technology improved over time along with durable goods. Surgery followed suit and additional techniques were developed to treat soft and bony structures of the entire upper airway (nose, palate and tongue base). This review will only focus on the contemporary surgical methods that have demonstrated relatively consistent positive clinical outcomes. Not all surgical and medical treatment modalities are successful or even partially successful for every patient. Advances in the treatment of OSAS are hindered by the fact that the primary etiology is still unknown. However, both medicine and surgery continue to improve diagnostic and treatment methods. Methods of diagnosis as well as treatment regimens should always include both medical and surgical collaborations so the health and quality of life of our patients can best be served.

Abstract

Surgical treatment of obstructive sleep apnea syndrome (OSAS) has been available in some form for greater than three decades. Early management for airway obstruction during sleep relied on tracheotomy which although life saving was not well accepted by patients. In the early eighties two new forms of treatment for OSAS were developed. Surgically a technique described as a uvulopalatopharyngoplasty (UPPP) was used to treat the retropalatal region for snoring and sleep apnea. Concurrently sleep medicine developed a nasal continuous positive airway pressure (CPAP) device to manage nocturnal airway obstruction. Both of these measures were used to expand and stabilize the pharyngeal airway space during sleep. The goal for each technique was to limit or alleviate OSAS. Almost 30 yr later these two treatment modalities continue to be the mainstay of contemporary treatment. As expected, CPAP device technology improved over time along with durable goods. Surgery followed suit and additional techniques were developed to treat soft and bony structures of the entire upper airway (nose, palate and tongue base). This review will only focus on the contemporary surgical methods that have demonstrated relatively consistent positive clinical outcomes. Not all surgical and medical treatment modalities are successful or even partially successful for every patient. Advances in the treatment of OSAS are hindered by the fact that the primary etiology is still unknown. However, both medicine and surgery continue to improve diagnostic and treatment methods. Methods of diagnosis as well as treatment regimens should always include both medical and surgical collaborations so the health and quality of life of our patients can best be served.

참고문헌 (65)

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관련 논문AI추천

Surgical Algorithm for Obstructive Sleep Apnea: An Update유명상, Robert Wayne Riley, Stanley Yung Chuan Liu대한이비인후과학회 · Clinical and Experimental Otorhinolaryngology2020 · 제13권 제3호폐쇄성 수면 무호흡증의 외과적 접근이의룡대한치과의사협회 · 대한치과의사협회지2021 · 제59권 제12호Five-Year Subjective Outcomes of Obstructive Sleep Apnea Surgery: A Multiinstitutional Study구수권, 김성완, 김유석, 김정훈, 김효열, 원태빈, 이승훈, 이재서, 정유삼, 조규섭, 조재훈, 최지호대한이비인후과학회 · Clinical and Experimental Otorhinolaryngology2015 · 제8권 제4호폐쇄성 수면무호흡증(Obstructive Sleep Apnea)의 외과적 처치김태경, 이덕원대한치과의사협회 · 대한치과의사협회지2015 · 제53권 제12호A Prospective Study of the Surgical Outcome of Simple Uvulopalatopharyngoplasty (UPPP), UPPP Combined With Genioglossus Advancement or Tongue Base Advancement for Obstructive Sleep Apnea Hypopnea Syndrome Patients With Multilevel ObstructionCaiyun Zhang, Hongliang Zheng, Minhui Zhu, Shicai Chen, Siwen Xia, Song Shi, Yanghui Xia대한이비인후과학회 · Clinical and Experimental Otorhinolaryngology2015 · 제8권 제2호Maxillomandibular Advancement and Upper Airway Stimulation: Extrapharyngeal Surgery for Obstructive Sleep Apnea유명상, Badr Ibrahim, Robert Wayne Riley, Stanley Yung Chuan Liu대한이비인후과학회 · Clinical and Experimental Otorhinolaryngology2020 · 제13권 제3호

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