Coblation endoscopic lingual lightening (CELL) for obstructive sleep apnea

详细信息    查看全文

• 作者：Hsueh-Yu Li ; Li-Ang Lee ; Eric J. Kezirian
• 关键词：Coblation endoscopic lingual lightening ; Tongue base obstruction ; Obstructive sleep apnea ; Uvulopalatopharyngoplasty
• 刊名：European Archives of Oto-Rhino-Laryngology
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：273
• 期：1
• 页码：231-236
• 全文大小：999 KB
• 参考文献：1.Kezirian EJ, Hussey HM, Brietzke SE, Cohen SM, Davis GE, Shin JJ, Weinberger DG, Cabana MD (2012) Hypopharyngeal surgery in obstructive sleep apnea: practice pattern, perceptions, and attitudes. Otolaryngol Head Neck Surg 147:964–971PubMed CrossRef
  2.Kezirian EJ, Goldberg AN (2006) Hypopharyngeal surgery in obstructive sleep apnea: an evidence-based medicine review. Arch Otolaryngol Head Neck Surg 132:206–213PubMed CrossRef
  3.Lin HC, Friedman M, Chang HW, Gurpinar B (2008) The efficacy of multilevel surgery of the upper airway in adults with obstructive sleep apnea/hypopnea syndrome. Laryngoscope 118:902–908PubMed CrossRef
  4.Fujita S, Woodson BT, Clark JL, Wittig R (1991) Laser midline glossectomy as a treatment for obstructive sleep apnea. Laryngoscope 101:805–809PubMed CrossRef
  5.Woodson BT, Fujita S (1992) Clinical experience with lingualplasty as part of the treatment of severe obstructive sleep apnea. Otolaryngol Head Neck Surg 107:40–48PubMed CrossRef
  6.Mickelson SA, Rosenthal L (1997) Mildline glossectomy and epiglottidectomy for obstructive sleep apnea syndrome. Laryngoscope 107:614–619PubMed CrossRef
  7.Chabolle F, Wagner I, Blumen M, Sequert C, Fleury B, de Dieuleveult T (1999) Tongue base reduction with epiglottoplasty: a treatment for severe obstructive sleep apnea. Laryngoscope 109:1273–1280PubMed CrossRef
  8.Li HY, Wang PC, Hsu CY, Chen NH, Lee LA, Fang TJ (2004) Same-stage palatopharyngoplasty and hypopharyngeal surgery for severe obstructive sleep apnea. Acta Otolaryngol 124:820–826PubMed CrossRef
  9.Li HY (2009) Midline laser glossectomy with linguoplasty: treatment of obstructive sleep apnea. In: Friedman M (ed) Sleep apnea and snoring: surgical and non-surgical therapy. Saunders, Philadelphia, pp 287–291CrossRef
  10.Robinson S, Lewis R, Norton A, McPeake S (2003) Ultrasound-guided radiofrequency submucosal tongue-base excision for sleep apnoea: a preliminary report. Clin Otolaryngol Allied Sci 28:341–345PubMed CrossRef
  11.Woodson BT (2007) Innovative technique for lingual tonsillectomy and midline partial glossectomy for obstructive sleep apnea. Oper Techn Otolaryngol Head Neck Surg 18:20–28CrossRef
  12.Babademez MA, Ciftci B, Acar B, Yurekli MF, Karabulut H, Yilmaz A, Karasen RM (2010) Low-temperature bipolar radiofrequency ablation (coblation) of the tongue base for supine-position-associated obstructive sleep apnea. ORL J Otorhinolaryngol Relat Spec 72:51–55PubMed CrossRef
  13.Babademez MA, Yorubulut M, Yurekli MF, Gunbey E, Baysal S, Acar B, Karasen RM (2011) Comparison of minimal invasive techniques in tongue base surgery in patients with obstructive sleep apnea. Otolaryngol Head Neck Surg 145:858–864PubMed CrossRef
  14.Gunawardena I, Robinson S, MacKay S, Woods CM, Choo J, Esterman A, Carney AS (2013) Submucosal lingualplasty for adult obstructive sleep apnea. Otolaryngol Head Neck Surg 148:157–165PubMed CrossRef
  15.Suh GD (2013) Evaluation of open midline glossectomy in the multilevel surgical management of obstructive sleep apnea syndrome. Otolaryngol Head Neck Surg 148:166–171PubMed CrossRef
  16.Friedman M, Ibrahim H, Joseph NJ (2004) Staging of obstructive sleep apnea/hypopnea syndrome: a guide to appropriate treatment. Laryngoscope 114:454–459PubMed CrossRef
  17.Dreher A, dela Chaux R, Klemens C, Werner R, Baker F, Barthlen G, Rasp G (2005) Correlation between otolaryngologic evaluation and severity of obstructive sleep apnea syndrome. Arch Otolaryngol Head Neck Surg 131:95–98PubMed CrossRef
  18.Iber C, Ancoli-Israel S, Chesson AL, Quan SF (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, 1st edn. American Academy of Sleep Medicine, Westchester
  19.Li HY, Lee LA (2009) (Relocation pharyngoplasty for obstructive sleep apnea. Laryngoscope 119:2472–2477PubMed CrossRef
  20.Sher AE, Schechtman KB, Piccirillo JF (1996) The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 19:156–177PubMed
  21.Lauretano AM, Li KK, Caradonna DS, Khosta RK, Fried MP (1997) Anatomic location of the tongue base neurovascular bundle. Laryngoscope 107:1057–1059PubMed CrossRef
  22.Hou TN, Shao JY, Fang SH (2012) The definition of the V zone for the safety space of functional surgery of the tongue. Laryngoscope 122:66–70PubMed CrossRef
  23.Vicini C, Dallan L, Canzi P, Frassineti S, La Pietra MG, Montevecchi F (2010) Transoral robotic tongue base resection in obstructive apnea–hypopnea syndrome: a preliminary report. ORL J Otorhinolaryngol Relat Spec 72:22–27PubMed CrossRef
  24.Friedman M, Hamilton C, Samuelson CG, Kelley K, Taylor D, Pearson-Chauhan K, Maley A, Taylor R, Venkatesan TK (2012) Transoral robotic glossectomy for the treatment of obstructive sleep apnea–hypopnea syndrome. Otolaryngol Head Neck Surg 146:854–862PubMed CrossRef
  25.Lin HS, Rowley JA, Badr MS, Folbe AJ, Yoo GH, Victor L, Mathog RH, Chen W (2013) Transoral robotic surgery for treatment of obstructive sleep apnea–hypopnea syndrome. Laryngoscope 123:1811–1816PubMed CrossRef
  
• 作者单位：Hsueh-Yu Li (1) (2)
  Li-Ang Lee (1)
  Eric J. Kezirian (3)
  
  1. Department of Otolaryngology, Sleep Center, Linkou-Chang Gung Memorial Hospital, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
  2. Department of Sleep Medicine, Royal Infirmary Edinburgh, Edinburgh, UK
  3. Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Otorhinolaryngology
  Neurosurgery
  Head and Neck Surgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1434-4726

文摘

This study investigated the feasibility, safety and efficacy of Coblation endoscopic lingual lightening (CELL) surgery for obstructive sleep apnea (OSA). This study was a retrospective case series in a tertiary referral sleep center. Twenty-five adults with moderate to severe OSA and determined to have retropalatal and tongue base obstruction based on Friedman tongue position III and fiberoptic endoscopy underwent CELL in combination with modified uvulopalatopharyngoplasty, known as relocation pharyngoplasty. CELL involves transoral resection of tongue base muscle tissue and lingual tonsil using Coblation under endoscopic guidance. The mean operation time for CELL was 42.6 ± 13.7 min. Total blood loss for CELL plus relocation pharyngoplasty was <50 ml in all patients. Mean postoperative pain score (sum of total pain scores/sum of total hospitalization day, visual analog scale, 0–10) was 2.6 ± 0.6. Postoperative bleeding and taste disturbance extending beyond 3 months occurred in one patient (4 %) individually. No patients reported tongue weakness or speech dysfunction. Epworth sleepiness scale improved from 9.6 ± 4.9 to 7.5 ± 4.3 (p = 0.023). Apnea–hypopnea index decreased from 45.7 ± 21.7 to 12.8 ± 8.2 events/hour (p < 0.001) 6 months after surgery. The overall response rate was 80 %. CELL is feasible, safe and effective in treating tongue base obstruction in OSA patients who underwent simultaneous relocation pharyngoplasty.