156폐쇄성 수면무호흡질환에서 구개근 절제술과 구개근 및 보존적 구개수 절제술의 술 후 결과 비교 = Comparison of Postoperative Results between PMR and PMR with Partial Uvulectomy in Treating Obstructive Sleep Apnea

다국어 초록 (Multilingual Abstract)

Background and Objectives：Palatal muscle resection (PMR) is a surgical method that treats retropalatal airwayobstruction. Sometimes elongated uvula can aggravate obstructive symptom in obstructive sleep apnea (OSA)patients. Uvulectomy is usually done in such cases to resolve the obstructive effect of the uvula. The purpose ofthis study was to compare postopreative results of PMR and PMR with partial uvulectomy in treating obstructivesleep apnea (OSA). Materials and Methods：Thirty-three patients with OSA due to retropalatal obstruction weretreated with surgical method from June 2011 to May 2013. Seventeen patients underwent PMR and 16 patientsunderwent PMR with partial uvulectomy. Surgical method was decided by preoperative drug induced sleep en-doscopy (DISE) analysis. Postoperative satisfaction criteria were analyzed before and after 3 months of each sur-gery via questionnaires based on visual analogue scale (VAS) of snoring, sleep apnea, and daytime sleepiness. Post-operative complications were analyzed before the surgery as well as 1, 4, and 12 weeks after the surgery viaquestionnaires based on VAS about foreign body sensation, dry throat, velopharyngeal insufficiency, swallowingdifficulty, and voice change. Results：Postoperative satisfactions were significantly (p＜0.05) improved in bothgroups. There was no significant (p＞0.05) difference in postoperative satisfactions between the two groups. For-eign body sensation and dry throat were significantly (p＜0.05) increased in PMR with partial uvulectomy group.
But these complications were resolved within 3 months. Conclusions：The PMR with partial uvulectomy grouphad more complications than the PMR group. Our results suggested that PMR with partial uvulectomy was pref-erable for cases requiring uvulectomy because some complications were resolved spontaneously

참고문헌 (Reference)

1 이현민, "폐쇄성 수면무호흡증 환자에서 구개수구개피판술과 구개근절제술의 수술 결과에 대한 비교 분석" 대한이비인후과학회 54 (54): 467-472, 2011

2 김태헌, "코골이 환자의 치료를 위한 구개근절제술" 대한이비인후과학회 51 (51): 1119-1123, 2008

3 구수권, "수면무호흡증 환자에서 시행한 구개근 절제술의 임상적 안전성" 대한비과학회 19 (19): 26-31, 2012

4 Sher AE, "Upper airway surgery for obstructive sleep apnea" 6 (6): 195-212, 2002

5 Huang MH, "Structure of the musculus uvulae: functional and surgical implications of an anatomic study" 34 (34): 466-474, 1997

6 Olofsson K, "Structure of the human uvula" 119 (119): 712-717, 1999

7 Han D, "Revised uvulopalatopharyngoplasty with uvula preservation and its clinical study" 67 (67): 213-219, 2005

8 Goh YH, "Quality of life 17 to 20 years after uvulopalatopharyngoplasty" 117 (117): 503-506, 2007

9 Sériès F1, "Physiologic, metabolic, and muscle fiber type characteristics of musculus uvulae in sleep apnea hypopnea syndrome and in snorers" 95 (95): 20-25, 1995

10 Koo SK, "Pathophysiology of obstructive sleep apnea" 12 (12): 15-21, 2001

11 Kamami YV, "Outpatient treatment of sleep apnea syndrome with CO2 laser: laser-assisted UPPP" 23 (23): 395-398, 1994

12 Series F, "Muscle fiber area distribution of musculus uvulae in obstructive sleep apnea and non-apneic snorers" 24 (24): 410-415, 2000

13 Stauffer JL, "Morphology of the uvula in obstructive sleep apnea" 140 (140): 724-728, 1989

14 Hernándex-Gancedo C, "Monitoring sedation in critically ill patients: bispectral index, Ramsay and observer scales" 23 (23): 649-653, 2006

15 Roosli C, "Long-term results and complications following uvulopalatopharyngoplasty in 116 consecutive patients" 263 (263): 754-758, 2006

16 Woodson BT, "Histopathologic changes in snoring and obstructive sleep apnea syndrome" 101 (101): 1318-1322, 1991

17 Grøntved AM, "Complaints and satisfaction after uvulopalatopharyngoplasty" 543 : 190-192, 2000

18 Koo SK, "Analysis of obstruction site in obstructive sleep apnea syndrome patients by drug induced sleep endoscopy" 34 (34): 626-630, 2013

19 Powell N, "A reversible uvulopalatal flap for snoring and sleep apnea syndrome" 19 (19): 593-599, 1996