Defining Safety Space for Functional Tongue Surgery in Korean Male Obstructive Sleep Apnea Syndrome Patients; Analysis on Spatial Relation of the Tongue and the Lingual Artery
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Objectives Upon operation of the tongue base for obstructive sleep apneasyndrome (OSAS), the lingual artery and the hypoglossal nerve are put at risk of injury,resulting in fatal complications such as massive bleeding upon damage. We studied the courseof lingual artery in its relation with the tongue in OSAS patients and compared it with the ageand-gender-matched normal population. Subjects and Method Korean male patients confirmed with OSAS by polysomnography,including those who had contrast-enhanced computed tomography (ceCT) of the head andneck, were defined as “OSAS group.” Patients who had their ceCT image during the samestudy period were defined as the “control group.” The control group was paired with the OSASgroup by age and sex. By using foramen cecum (FC) as the main reference point, four referencemarks were defined. For each reference point, the distance between both lingual arteriesand the depth of the lingual artery from the lingual surface of the tongue were evaluated. Results The depth of the lingual artery from the lingual surface of the tongue in the OSASgroup (25.1±8.6 mm) was significantly different from the control (29.5±5.9 mm) at 1 cm anteriorto the FC level (p<0.014). The width of both lingual arteries was narrower in the OSASgroup (20.9±2.9) than in the control (24.3±6.1) at the FC level (p<0.003). Conclusion The course of lingual artery and its spatial relation with the tongue in Koreanmale OSAS patients differs from the matched normal population.
Abstract
Background and Objectives Upon operation of the tongue base for obstructive sleep apneasyndrome (OSAS), the lingual artery and the hypoglossal nerve are put at risk of injury,resulting in fatal complications such as massive bleeding upon damage. We studied the courseof lingual artery in its relation with the tongue in OSAS patients and compared it with the ageand-gender-matched normal population. Subjects and Method Korean male patients confirmed with OSAS by polysomnography,including those who had contrast-enhanced computed tomography (ceCT) of the head andneck, were defined as “OSAS group.” Patients who had their ceCT image during the samestudy period were defined as the “control group.” The control group was paired with the OSASgroup by age and sex. By using foramen cecum (FC) as the main reference point, four referencemarks were defined. For each reference point, the distance between both lingual arteriesand the depth of the lingual artery from the lingual surface of the tongue were evaluated. Results The depth of the lingual artery from the lingual surface of the tongue in the OSASgroup (25.1±8.6 mm) was significantly different from the control (29.5±5.9 mm) at 1 cm anteriorto the FC level (p<0.014). The width of both lingual arteries was narrower in the OSASgroup (20.9±2.9) than in the control (24.3±6.1) at the FC level (p<0.003). Conclusion The course of lingual artery and its spatial relation with the tongue in Koreanmale OSAS patients differs from the matched normal population.
참고문헌 (26)
- Boudewyns AN, "Site of upper airway obstruction in obstructive apnoea and influence of sleep stage", Eur Respir J, 10(11), pp.2566~2572 (1997)
- Levin BC, "Uvulopalatopharyngoplasty for snoring : Long-term results", Laryngoscope, 104(9), pp.1150~1152 (1994)
- Farmer WC, "Site of airway collapse in obstructive sleep apnea after uvulopalatopharyngoplasty", Ann Otol Rhinol Laryngol, 109(6), pp.581~584 (2000)
- Friedman M, "Evaluation of submucosal minimally invasive lingual excision technique for treatment of obstructive sleep apnea", hypopnea syndrome, 2008, pp.139(3), 378~384
- Hsieh TH, "Simultaneous midline laser glossectomy with palatopharyngeal surgery for obstructive sleep apnoea syndrome", Int J Clin Pract, 59(4), pp.501~503 (2005)
- Li S, "Lingual artery CTA-guided midline partial glossectomy for treatment of obstructive sleep apnea hypopnea syndrome", Acta Otolaryngol, 133(7), pp.749~754 (2013)
- Sorrenti G, "One-phase management of severe obstructive sleep apnea : Tongue base reduction with hyoepiglottoplasty plus uvulopalatopharyngoplasty", Otolaryngol Head Neck Surg, 135(6), pp.906~910 (2006)
- Lauretano AM, "Anatomic location of the tongue base neurovascular bundle", Laryngoscope, 107(8), pp.1057~1059 (1997)
- Herzog M, "Pseudoaneurysm of the lingual artery after temperature-controlled radiofrequency tongue base reduction : A severe complication", Laryngoscope, 116(4), pp.665~667 (2006)
- Cohen DS, "Establishing a danger zone : An anatomic study of the lingual artery in base of tongue surgery", Laryngoscope, 127(1), pp.110~115 (2017)
- Hou T, "The definition of the V zone for the safety space of functional surgery of the tongue", Laryngoscope, 122(1), pp.66~70 (2012)
- Lopez R, "Vascular territories of the tongue : Anatomical study and clinical applications", Surg Radiol Anat, 29(3), pp.239~244 (2007)
- Wu D, "Analysis of the difference in the course of the lingual arteries caused by tongue position change", Laryngoscope, 125(3), pp.762~766 (2015)
- Low S, "Rationale for redefining obesity in Asians", Ann Acad Med Singap, 38(1), pp.66~69 (2009)
- Ito E, "The international classification of sleep disorders, third edition. American Academy of Sleep Medicine. Includes bibliographies and index", Nihon Rinsho, 73(6), pp.916~923 (2015)
- Chirinos JA, "CPAP, weight loss, or both for obstructive sleep apnea", N Engl J Med, 370(24), pp.2265~2275 (2014)
- Chang CC, "Real-time, intraoperative, ultrasound-assisted transoral robotic surgery for obstructive sleep apnea", Laryngoscope, 131(4), pp.E1383~E1390 (2021)
- Abd-El-Malek S, "Observations on the morphology of the human tongue", J Anat, 73(Pt 2), pp.201~210 (1939)
- Nashi N, "Lingual fat at autopsy", Laryngoscope, 117(8), pp.1467~1473 (2007)
- Gualtieri T, "A new landmark for lingual artery identification during transoral surgery : Anatomic-radiologic study", Head Neck, 43(5), pp.1487~1498 (2021)
- Ibrahim A, "Radiological and cadaveric study of anatomical safe zone for transoral base of tongue surgery", J Robot Surg (2020)
- Ye J, "Anatomic characteristics of lingual artery and midline glossectomy", Zhonghua Er Bi Yan Hou Ke Za Zhi, 36(1), pp.55~57 (2001)
- Bayat M, "Cephalometric risk factors of obstructive sleep apnea", Cranio, 35(5), pp.321~326 (2017)
- Cuccia AM, "Obesity and craniofacial variables in subjects with obstructive sleep apnea syndrome : Comparisons of cephalometric values", Head Face Med, 3, pp.41~ (2007)
- Yu X, "Cephalometric analysis in obese and nonobese patients with obstructive sleep apnea syndrome", Chest, 124(1), pp.212~218 (2003)
- Lu H, "Application of 3D reconstruction for midline glossectomy in OSA patients", Eur Arch Otorhinolaryngol, 277(3), pp.925~931 (2020)