共查询到20条相似文献,搜索用时 15 毫秒
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Navid Nourizadeh Bashir Rasoulian Mohammad Reza Majidi Amir Rezaei Ardani Fariborz Rezaeitalab Hadi Asadpour 《Auris, nasus, larynx》2019,46(6):866-870
ObjectivesEvaluate the effect of functional endoscopic sinus surgery (FESS) for nasal polyposis on sleep efficiency and polysomnographic parameters.Subjects and methodsThis clinical trial was conducted on 15 patients with bilateral massive sinonasal polyposis who underwent FESS between August 2012 and September 2013. All participants were evaluated subjectively by employing the Pittsburgh Sleep Quality Index (PSQI) questionnaire and objectively (provided by polysomnographic parameters) before and 2 months after surgery.ResultsThe evaluation of subjective criteria of sleep quality assessed by PSQI showed significant improvement, particularly in nocturnal awakening (P = 0.002). However, Apnea Hypopnea Index (AHI) was not reduced significantly after surgery (P = 0.233). Among patients who had suffered from obstructive sleep apnea, AHI was improved in 7 patients, deteriorated in 3 patients, and did not change in 1 patient. Although the mean duration of REM sleep stage increased from 15.2 ± 10.7 to 18.9 ± 7.9, this change was not statistically significant. Furthermore, arousal index decreased dramatically from 31.6 to 17.1 (P = 0.02) and sleep efficiency index was improved after the surgery (P = 0.008).ConclusionsThis study documented the effect of resuming nasal cavity patency on improvement of sleep efficiency after FESS. In spite of insignificant effect of FESS on apnea index, alteration of other sleep parameters like arousal index following surgery may have a positive effect on sleep quality. 相似文献
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目的 通过分析耳鼻咽喉头颈外科诊疗特点以及医疗纠纷现状,提出针对耳鼻咽喉头颈外科医疗纠纷的防御对策及干预措施.方法 对医务人员和患者医疗纠纷的认识等情况以及既往医疗纠纷病例进行调查分析,提出减少或避免耳鼻咽喉头颈外科医疗纠纷的防御对策,并运用于临床.以2016年全年医疗纠纷数量及患者对医疗满意度等指标为对照组,2017... 相似文献
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Andrea Marzetti Massimiliano Tedaldi Francesco Maria Passali 《Clinical and experimental otorhinolaryngology》2013,6(1):18-22
Objectives
Obstructive sleep apnea (OSA) is a common disorder affecting at least 2% to 4% of adult population characterized by the collapse of the pharyngeal airway. It is well established that retropalatal region is the most common site of obstruction. Consequently, many surgical techniques have been introduced. The purpose of this study is to present our preliminary results in the anterior palatoplasty (AP) compared with results of uvulopalatal flap (UPF).Methods
Thirty-eight consecutive patients with mild-moderate OSA were prospectively enrolled into a randomised surgical protocol. Surgical success was measured primarily by satisfactory reduction in snoring, as reported by snoring assessment questionnaire (SQ) of sleep partners. Secondary outcomes measures included improvement in the Epworth Sleepiness Scale (ESS) scores, changes in the magnitude of pharyngeal collapse, and postoperative pain intensity.Results
The ESS after AP improved from a preoperative value 8.5±3.7 to a postoperative mean of 4.9±3.2 (P<0.001) after UPF improved from a preoperative value of 8.1±3.5 to 5.2±3.2 postoperatively (P<0.001). The results of satisfactory reduction in the volume of snoring and response at polysomnographic data were also similar in both procedures. We reported a statistically significant difference of the collapse noted at Müller manoeuvre that improved from 2.7±1.0 on average, to 1.1±0.9 (P<0.001) after AP and with a lesser extent, (from 2.8±1.1 on average to 1.8±1.1; P<0.05), after UPF. The mean duration of pain was 10.8 days for UPF patients and 7.1 days for AP patients. The mean pain score in the first 3 days, was 6.8 in UPF patients and 5.1 in AP patients.Conclusion
The subjective and objective improvements evidenced may suggest how AP is far superior to other techniques aimed at creating a palatal fibrotic scar. In the light of these results we can suggest AP procedure as more practical and comfortable when compared to UPF. 相似文献8.
《Acta oto-laryngologica》2012,132(8):990-994
Increased upper airway collapsibility has been suspected of being involved in the pathogenesis of sleep-related diseases. It is assumed that patients with severe obstructive sleep apnea syndrome (OSAS) show a stronger collapse of the upper airway compared with habitual snorers. It was the objective of this study to analyze the patterns of upper airway collapse in habitual snorers and patients with OSAS and to correlate these results with data from polysomnography. Endoscopy was carried out during drug-induced sleep (with propofol) and collapsibility was analyzed at two major levels (palatal and tongue base). A total of 207 habitual snorers and 117 patients with OSAS underwent endoscopy after overnight polysomnography in our sleep laboratory. In 95% of cases we were able to induce snoring during drug-induced sleep. The collapsibility in the area of the base of the tongue correlated with higher values of the respiratory disturbance index (RDI) as recorded by standard polysomnography. Patients with OSAS showed significantly stronger collapsibility compared with snorers. The difference was more evident at the tongue-base level. We found no significant correlation between the applied CPAP pressure and collapsibility in patients with OSAS. These results show that collapsibility at the tongue-base level is a factor relevant in sleep-related breathing disorders. 相似文献
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David J. Terris 《The Laryngoscope》1999,109(7):1045-1050
Objective: To document the capacity of surgery for obstructive sleep apnea (OSA) to incorporate techniques that incidentally improve the cosmetic features of the patients. Study Design: Retrospective analysis of surgical outcomes at an academic practice. Methods: Moderate to severe OSA usually requires multilevel pharyngeal surgery, including tongue base surgery. The surgical procedures, including hyoid myotomy and mandibular osteotomy with tongue advancement, afford the opportunity to address cosmetic deficits, such as microgenia and excessive submental skin and fat. Outcomes achieved using these procedures over a 4-year period were analyzed. Results: Of 428 consecutive patients presenting for evaluation of sleep-related breathing disorders, 212 were deemed surgical candidates. Ninety-seven of these had office-based procedures for snoring, upper airway resistance syndrome, or mild OSA. The remaining 115 had formal surgical procedures done, and 68 of these had multilevel pharyngeal surgery. Of these, 12 had defined cosmetic deficiencies that were addressed at the time of the sleep apnea surgery. There were 7 men and 5 women, with a mean age of 48.2 years. The group was moderately obese (mean BMI = 31.8) and had moderate to severe OSA (mean RDI = 37.0, mean LSAT = 78%). Cosmetic deficits identified included turkey gobbler deformity (n = 8), microgenia (n = 6), excessive submental fat (n = 2), and nasal deformity (n = 1); several patients had more than one addressable problem. All patients achieved an improved postoperative appearance. Representative photographs are presented. Conclusions: A surgical approach to the management of sleep apnea affords an opportunity to also address cosmetic deficiencies, including excessive submental skin and fat, microgenia, and nasal deformities. 相似文献
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目的 探讨同期鼻腔手术+悬雍垂腭咽成型术治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效情况。方法 对40例伴有鼻阻塞的OSAHS患者分A、B两组,A组行鼻腔手术+悬雍垂腭咽成型术(UPPP),B组行悬雍垂腭咽成型术,术后6个月复查睡眠监测,比较术前术后呼吸暂停低通气指数(AHI)。结果 A、B两组OSAHS患者术后AHI平均值均降低,A组有效率较B组高。结论 同期鼻腔手术+悬雍垂腭咽成型术治疗鼻腔、咽腔双平面阻塞的OSAHS患者效果可靠,值得推广。 相似文献
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为预防重症阻塞性睡眠呼吸暂停综合征(OSAS)治疗的并发症,报道1990~1993年9例重症OSAS,行悬雍垂腭咽成形术(UPPP)前预防性气管切开术的经验。初步提出预防性切开术的适应证:①夜间睡眠期最低血氧饱和度低于50%;②呼吸紊乱指数大于50;③伴有效严重的心、肺和脑并发症;④有严重缺氧表现;⑤肥胖、颈粗短、舌根肥厚后坠者。 相似文献
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Naraghi Mohsen Adil Susan Bastaninejad Shahin Dabiran Soheila 《International journal of pediatric otorhinolaryngology》2014
Objective
To assess the quality of life in children with adenotonsillar problems before and after adenotonsillectomy in short term follow-up.Methods
Quasi-experimental study (before and after study) of children with adenotonsillar problems at Tehran University of Medical Sciences, Amir’Alam hospital. Eighty six pediatric patients aged 3 through 13 years (58 boys and 28 girls) who underwent adenotonsillectomy, for treatment of sleep disordered breathing or recurrent throat infection, were recruited. Parents completed OSA-18 quality of life survey and Brouillette score questionnaire before and one month after surgery.Results
Reliability of the Brouillette score and OSA-18 survey was established by evaluating the Cronbach α value. Cronbach α for Brouillette score was 0.70 and for OSA-18 survey it was 0.88. Preoperative values for the OSA-18 total and domain scores were high in children: mean ± SD; 61.65 ± 20.78. Preoperative values for the Brouillette score were: mean ± SD; 0.41 ± 2.34. The total OSA-18 survey score and the scores for all domains showed significant improvement after surgery: mean ± SD; 28.01 ± 9.09 (P < 0.001). Post-operative Brouillette score had a significant improvement: mean ± SD; −3.57 ± 0.91 (P < 0.001).Conclusion
Considering the OSA-18 survey and Brouillete score results, surgical therapy with adenotonsillectomy is associated with marked improvement in quality of life in both obstructive and infective adenotonsillar disease. 相似文献14.
Sleep disordered breathing: surgical outcomes in prepubertal children 总被引:10,自引:0,他引:10
OBJECTIVE: To evaluate the treatment outcomes of sleep disordered breathing (SDB) in prepubertal children 3 months following surgical intervention. STUDY DESIGN: Retrospective investigation of 400 consecutively seen children with SDB who were referred to otolaryngologists for treatment. METHOD: After masking the identities and conditions of the children, the following were tabulated: clinical symptoms, results of clinical evaluation and polysomnography at entry, the treatment chosen by the otolaryngologists, and clinical and polysomnographic results 3 months after surgery. RESULTS: Treatment ranged from nasal steroids to various surgical procedures. Adenotonsillectomy was performed in only 251 of 400 cases (68%). Four cases included adenotonsillectomy in conjunction with pharyngoplasty (closure of the tonsillar wound by suturing the anterior and posterior pillar to tighten the airway). Persistent SDB was seen in 58 of 400 children (14.5%), and an additional 8 had persistent snoring. Best results were with adenotonsillectomy. CONCLUSION: SDB involves obstruction of the upper airway, which may be partially due to craniofacial structure involvement. The goal of surgical treatment should be aimed at enlarging the airway, and not be solely focused on treating inflammation or infection of the lymphoid tissues. This goal may not be met in some patients, thus potentially contributing to residual problems seen after surgery. The possibility of further treatment, including collaboration with orthodontists to improve the craniofacial risk factors, should be considered in children with residual problems. 相似文献
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目的 探讨对伴有鼻阻塞的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者,仅单纯行鼻部手术,术后对患者睡眠质量、结构、体位及紊乱性睡眠呼吸(SDB)的影响。方法 对鼻阻塞OSAHS患者30例鼻部手术前后,进行多导睡眠仪(PSG)监测和Epworth嗜睡量表(ESS)评分,比较手术前后睡眠质量、结构、体位和SDS变化。结果 睡眠效率[(86.4±6.4)% ~ (89.4±6.8)%, P=0.043]、ESS评分(10.08±3.3 ~ 8.1±3.3, P=0.001)和睡眠R期[(15.5±4.0)%~(18.8±4.7)%, P=0.006]手术后有明显改变。觉醒指数(ArI)、其他睡眠期、侧卧位占睡眠时间比例、呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)和鼾声术后差异无统计学意义。结论 单纯鼻腔手术可部分改善睡眠质量和结构,但对体位、鼾声和阻塞性睡眠呼吸暂停无影响。 相似文献
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目的 通过对解剖学、影像学、神经导航三种测量方式精确度的对比,对数字化颅底外科手术的可行性进行量化评估。方法 取颅底标本25个,对前半规管-卵圆孔之间的距离(50侧),分别进行游标卡尺测量(解剖学测量)、影像学测量及神经导航测量。所得数据进行记录,并采用SPSS 19.0软件进行统计分析,比较三种测量方式各自的精确度。结果 ①解剖学测量的平均偏差(离均差平均值)>影像学测量数据与解剖学测量均数的平均偏差(P<0.01); ②神经导航测量的与解剖学测量均数的平均偏差>影像学测量与解剖学测量均数的平均偏差(P<0.01); ③神经导航测量的与解剖学测量均数的平均偏差略>解剖学测量的平均偏差, 但P(90%)>0.8。结论 ①影像学测量数据在评估个体解剖学特征方面的精密度,高于基于群体的解剖学测量数据;②神经导航系统在注册及应用中会出现一些偏差,影响神经导航系统的精确性;③即使不可避免地存在着误差,从统计学角度来看,神经导航测量依然无可否认地可视为与解剖学测量为等效(把握度高达90%)。 相似文献
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