논문KCI 등재
폐쇄성 수면 무호흡증의 외과적 치료
Surgical Treatment of Obstructive Sleep Apnea Syndrome
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초록
폐쇄성 수면 무호흡증의 치료방법으로 수술은 선택된 환자에게는 성공적일 수 있고 다른 치료법으로 치료가 어려운환자에게 2차치료로서 작용하거나 양압호흡기 등 다른 치료방법의 보조치료로서의 역할이 있다. 설하신경자극 등 새로운 수술 방법과 현존하는 수술법에 대한 환자선택법의 발전에 따라 향후에는 더 좋은 결과를 가져올지에 대한 추가적인연구가 필요하다.
Abstract
(OSAS). However, the CPAP device must be used every day and is associated with some discomfort. As a result, many patients do not comply with physician-recommended CPAP usage. Surgical intervention for OSAS eliminates issues with patient non-compliance. Although it is less effective than CPAP, surgery represents a feasible alternative for patients who are non-compliant with CPAP usage, have mild to moderate OSAS without significant comorbidities, or suffer from simple snoring. Nasal surgery can also reduce an individual’s CPAP pressure requirement and thus increase compliance. Of the various surgical procedures available, uvulopalatopharyngoplasty, which removes excess tissue from the soft palate and pharynx, is successful only in selected patients, while multilevel surgery is more effective. For example, maxillomandibular advancement is promising, although it is associated with potential morphological change in the airway. Radiofrequency ablation and palatal implants are minimally invasive interventions for simple snoring and mild OSAS. In morbidly obese patients, bariatric surgery has proven particularly effective. Finally and most recently, surgically implanted devices that stimulate the hypoglossal nerve have been investigated.
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