|
1000
|
Abstract/Summary
|
-
<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Background</jats:title>
<jats:p>The purpose of this study was to determine the therapeutic value of drug-induced sleep endoscopy (DISE) by comparing the outcomes of tongue base surgery based on Muller’s maneuver (MM) and those based on DISE in obstructive sleep apnea (OSA) patients.</jats:p>
</jats:sec><jats:sec>
<jats:title>Methods</jats:title>
<jats:p>Ninety-five patients who underwent the tongue base surgery in combination with palatal surgery for OSA at a tertiary referral hospital between March 2012 and March 2019 were enrolled in this retrospective comparative study. Forty-seven patients underwent MM for surgical decision and 48 patients underwent DISE in addition to MM for surgical decision. Surgical success was defined according to the Sher criteria (postoperative apnea-hypopnea index [AHI] < 20/h and ≥ 50% reduction in preoperative AHI), and AHI improvement (%) was defined as (preoperative AHI-postoperative AHI) × 100/preoperative AHI. For comparison between the MM and DISE groups, <jats:italic>p</jats:italic>-values were calculated using independent or paired t-tests for continuous variables and using chi-square test for categorical variables.</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>By comparing the results of MM and DISE, consensus on the tongue base level showed insignificant concordance (kappa = 0.017, <jats:italic>p</jats:italic> = 0.865), whereas that on the oropharynx level showed fair agreement (kappa =0.241, <jats:italic>p</jats:italic> = 0.005). AHI, supine AHI, rapid eyeball movement (REM) AHI, non-REM AHI, and nadir oxygen saturation were all significantly improved after the tongue base surgery in both groups. The MM group showed a significant improvement in the Epworth sleepiness scale after the tongue base surgery (<jats:italic>p</jats:italic> = 0.014), whereas the DISE group did not (<jats:italic>p</jats:italic> = 0.165). However, there was no significant difference in the AHI improvement (MM group = 47.0 ± 32.0, DISE group = 48.3 ± 35.4, <jats:italic>p</jats:italic> = 0.852) and surgical success (MM group = 42.6%, DISE group = 45.8%, <jats:italic>p</jats:italic> = 0.748) between the groups. Tonsil grade (<jats:italic>p</jats:italic> < 0.05) and occlusion at the oropharynx lateral wall (<jats:italic>p</jats:italic> = 0.031) were significantly related to surgical success in the MM group.</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>In the judgment of the tongue base surgery, MM and DISE findings showed poor agreement. DISE might affect the surgical decision on the tongue base surgery in OSA patients; however, there was a lack of evidence regarding the superiority of DISE over MM with respect to the surgical outcomes.</jats:p>
</jats:sec>
|
|
1000
|
Hinweis
|
-
DeepGreen-ID: 3999a0e70a3e4802bce89ca03db3e93a ; metadata provieded by: DeepGreen (https://www.oa-deepgreen.de/api/v1/), LIVIVO search scope life sciences (http://z3950.zbmed.de:6210/livivo), Crossref Unified Resource API (https://api.crossref.org/swagger-ui/index.html), to.science.api (https://frl.publisso.de/), ZDB JSON-API (beta) (https://zeitschriftendatenbank.de/api/), lobid - Dateninfrastruktur für Bibliotheken (https://lobid.org/resources/search)
|
