The efficacy of the improved tongue base suspension surgery combined with UPPP in the treatment of severe OSA

Abstract

Objective:This study was designed to show the preliminary efficacy and safety of the improved tongue base suspension surgery in severe obstructive sleep apnea(OSA) patients classified as Friedman Ⅱand Friedman Ⅲ. Method:The severe OSA patients diagnosed by PSG as Friedman Ⅱ type and Ⅲ type underwent surgery treatment. The tongue base of the patient was implanted with titanium plate and fixed on the chin of mandible. The UPPP surgery was performed with reference to H-UPPP. After surgery, the patients were followed up, PSG was re-examined and the change of various subjective and objective indicators of rehabilitation and adverse reactions were observed and recorded.Result: One hundred and two patients with severe OSA who were not tolerant or unwilling to use CPAP treatment were treated by the above surgical method. All the patients underwent surgery successfully and generally recovered about 1 month after the surgery without obvious tongue base pain, foreign body sensation or other discomfort. Eating and speaking function were as usual, the wound was healed well, and no serious infection or rejection was observed. The main postoperative adverse reactionwas tension line fracture(3 cases). Sixty-seven patients completed follow-up. At 3 to 6 months after surgery, the AHI, ESS sleepiness score and snore index were lower than those before surgery, while LSaO₂and CT 90% were higher than those before surgery(P<0.01). The AHI before surgery was 60.5± 22.4, and the average AHI after surgery was 27.8± 22.4. The effective rate of the surgery was 71.6% and the success rate was 58.2%. The AHI has dropped by an average of 54.0%, and snore improved by 63.9%. Conclusion: After preliminary clinical observation, the study suggests that the improved tongue base suspension with UPPP has satisfactory curative effect and feasibility for the treatment of severe OSA patients classified as Friedman Ⅱ type and Ⅲ type.