폐쇄성 수면무호흡증(Obstructive Sleep Apnea)의 외과적 처치
Surgical approach for treatment of obstructive sleep apnea
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Obstructive sleep apnea (OSA), most common respiratory disorder of?sleep, is characterized by intermittent partial or complete occlusions of the upper airway due to loss of upper airway dilating muscle activity during?sleep?superimposed on a narrow upper airway. Termination of these events usually requires arousal from?sleep?and results in sleep?fragmentation and hypoxemia, which leads to poor quality of sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences. Untreated OSA may cause, or be associated with, several adverse outcomes, including daytime sleepiness, increased risk for motor vehicle accidents, cardiovascular disease, and depression. Various treatments are available, including non-surgical treatment such as medication or modification of life style, continuous positive airway pressure (CPAP) and oral appliance (OA). Skeletal surgery for obstructive sleep apnea (OSA) aims to provide more space for the soft tissue in the oropharynx to prevent airway collapse during sleep. Conventional surgical techniques include uvopalatopharyngoplasty(UPPP), genioglossus advancement (GA), and maxillomandibular advancement (MMA). Surgical techniques, efficacy and complications of skeletal surgery are introduced in this review.
Abstract
Obstructive sleep apnea (OSA), most common respiratory disorder of?sleep, is characterized by intermittent partial or complete occlusions of the upper airway due to loss of upper airway dilating muscle activity during?sleep?superimposed on a narrow upper airway. Termination of these events usually requires arousal from?sleep?and results in sleep?fragmentation and hypoxemia, which leads to poor quality of sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences. Untreated OSA may cause, or be associated with, several adverse outcomes, including daytime sleepiness, increased risk for motor vehicle accidents, cardiovascular disease, and depression. Various treatments are available, including non-surgical treatment such as medication or modification of life style, continuous positive airway pressure (CPAP) and oral appliance (OA). Skeletal surgery for obstructive sleep apnea (OSA) aims to provide more space for the soft tissue in the oropharynx to prevent airway collapse during sleep. Conventional surgical techniques include uvopalatopharyngoplasty(UPPP), genioglossus advancement (GA), and maxillomandibular advancement (MMA). Surgical techniques, efficacy and complications of skeletal surgery are introduced in this review.
참고문헌 (29)
- Kim J, "Prevalence of sleepdisordered breathing in middle-aged Korean men and women", Am J Respir Crit Care Med, 170, pp.1108~1113 (2004)
- Malhotra, "Obstructive sleep apnoea", Lancet, 360, pp.237~245 (2002)
- Engleman HM, "Sleep. Sleepiness, cognitive function, and quality of life in obstructive sleep apnonea", hypopnoea syndrome, 2004, pp.59, 618~622
- Robinson GV, "Sleep. Obstructive sleep apnea", hypopnea syndrome and hypertension, 2004, pp.59, 1089~1094
- Marin JM, "Longterm cardiovascular outcomes in men with obstructive sleep apnoeahypopnoea with or without treatment with continuous positive airway pressure : an observational study", Lancet, 365, pp.1046~1053 (2005)
- Jean-Louis G, "Obstructive sleep apnea and cardiovascular disease: Role of the metabolic syndrome and its components", J Clin Sleep Med, 15(4(3)), pp.261~272 (2008)
- Blakley BW, "Nasal resistance and sleep apnea", Laryngoscope, 97, pp.752~754 (1987)
- Piche J, "Snoring, apnea, and nasal resistance", J Otolaryngol, 25, pp.150~154 (1996)
- Schwab RJ, "Principles and Practice of Sleep Medicine", pp.983~1000 (2005), Elesevier Saunders
- Koo SK, "Analysis of obstruction site in obstructive sleep apnea syndrome patients by drug induced sleep endoscopy", Am J Otolaryngol, 34, pp.626~630 (2013)
- Fujita S, "Evaluation of the effectiveness of uvulopalatopharyngoplasty", Laryngoscope, 95, pp.70~74 (1985)
- Kamami YV, "Outpatient treatment of snoring with CO2 laser : laser-assited UPPP", J Otolaryngol, 23, pp.395~398 (1994)
- Zohar Y, "Surgical treatment of obstructive sleep apnea : technical variation", Arch Otolaryngol Head Neck Surg, 119, pp.1023~1029 (1993)
- Schechtman KB, "Methodological and statistical problems in sleep apnea research : the literature on uvuloplaltopharyngolplasty", Sleep, 18, pp.659~666 (1996)
- Sher AE, "The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome", Sleep, 19, pp.156~177 (1996)
- Jason C, "Longterm follow-up of patients with obstructive sleep apnea treated with uvulopalatophtyngoplasty", Arch Otolaryngol Head Neck Surg, 123, pp.257~262 (1997)
- Goh YH, "Quality of life 17 to 20years after uvulopalatopharyngoplasty", Laryngoscope, 117, pp.503~506 (2007)
- Aurora RN, "Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults", Sleep, 33, pp.1408~1413 (2010)
- Weitsman ED, "Quantitative analysis of sleep and sleep apnea before and after tracheostomy in patients with the hypersomnia sleep apnea syndrome", Sleep, 3, pp.407~423 (1980)
- Kiran S, "A comparative study of complications and long term outcomes of Surgical Tracheostomy and two techniques of Percutaneous Tracheostomy", Indian J Crit Care Med, 19, pp.82~86 (2015)
- Riley RW, "Obstructive sleep apnea and the hyoid : a revised surgical procedure", Otolaryngol Head Neck Surg, 111, pp.717~721 (1994)
- Verse T, "Muli-level surgery for obstructive sleep apnea. Preliminary objective results", Laryngohinootologie, 83, pp.516~522 (2004)
- Li KK, "Obstructive sleep apnea and maxillomandibular advancement: an assessment of airway changes using radiographic and nasopharyngoscopic examinations", Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 60, pp.526~530 (2002)
- Li KK, "Long-Term Results of Maxillomandibular Advancement Surgery", Sleep & breathing = Schlaf & Atmung, 4, pp.137~140 (2000)
- Riley R, "Mandibular osteotomy and hyoid bone advancement for obstructive sleep apnea : a case report", Sleep, 7, pp.79~82 (1984)
- Li KK, "Overview of phase I surgery for obstructive sleep apnea syndrome", Ear, nose, & throat journal, 78, pp.836~837 (1999)
- Silverstein K, "Genioglossusmuscle attachments : an anatomic analysis and the implications for genioglossus advancement", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 90, pp.686~688 (2000)
- Epstein LJ, "Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults", Journal of clinical sleep medicine : JCSM :official publication of the American Academy of Sleep Medicine, 5, pp.263~276 (2009)
- Kim J, "Prevalence of sleepdisordered breathing in middle-aged Korean men and women", American journal of respiratory and critical care medicine, 170, pp.1108~1113 (2004)