电子鼻咽镜评估改良悬雍垂腭咽成形术中软腭切除范围的作用*

目的: 利用电子鼻咽镜测量Ⅱ型阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者上气道解剖结构,以指导在改良悬雍垂腭咽成形术中精准切除软腭范围,提高手术疗效。方法: 自2020年2月至10月,应用电子鼻咽镜,在清醒状态下,经鼻对38例Ⅱ型OSAHS患者腭部的长度及咽后壁派氏嵴的距离进行术前评估测量,采用完整保留悬雍垂及软腭游离缘改良术式,切除过长的软腭组织,平均切除软腭长度(10.3±3.7) mm。术后随访6～12月,复查腭部的长度及派氏嵴的距离,观察术后并发症及临床疗效。结果: 根据术前电子鼻咽镜测量结果,切除过长的软腭组织进行改良悬雍垂腭咽成形术,患者术后临床症状明显改善,无出现术后常见的并发症;PSG检测术前、后明显改善,其疗效有统计学意义(P＜0.05)。结论: 应用电子鼻咽镜对Ⅱ型OSAHS患者的上气道解剖结构进行测量,可以为手术治疗OSAHS患者提供准确的软腭切除范围,有效防止术后并发症的发生,提高手术疗效。

The role of electronic nasopharyngoscope in the evaluation of excising the soft palate range with modified UPPP

Objective: The upper airway anatomy of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) was measured using electronic nasopharyngeal lens, used to guide the precise resection of the soft palate range during the modified sarsaovatopharynthoplasty and improve the surgical efficacy. Methods: From February to October 2020, The length of the palate and the distance of Passvant's ridgy on the posterior pharyngeal wall of 38 patients with type II OSAHS,in a conscious state,were measured by electronic nasopharyngoscope via nose before operation,the improved operating methods witch the free edge of the soft palate and the uvula were preserved completely were adopted,and the longer soft palate tissue was removed.The average length of the excised soft palate was 10.3±3.7(mm). The length of the palate and the distance of Passvant's ridgy were reviewed during 6-12 months postoperative follow-up, and postoperative complications and clinical efficacy were observed. Results: According to the preoperative measurement results by electronic nasopharyngoscope, the postoperative clinical symptoms with the patients underwent modified uvulopalatopharyngoplasty after excision of the longer soft palate tissue were significantly improved without common postoperative complications. PSG was significantly improved before and after operation, and the curative effect was statistically significant (P＜0.05). Conclusion: Using electronic nasopharyngoscope to measure the upper airway anatomical structure of the patients with type II OSAHS for surgical treatment could provide an accurate range of soft palate to be resected, effectively prevent postoperative complications and improve surgical efficacy.