Reasonability in performing laser sculptural uvulopalatoplasty in patients with ronchopathy and obstructive sleep apnea syndrome
https://doi.org/10.37895/2071-8004-2023-27-4-26-34
Abstract
Purpose: to background the reasonability in performing laser sculptural uvulopalatoplasty in patients with ronchopathy and obstructive apnea sleep syndrome.
Materials and methods: the authors back grounded the application of laser sculptural uvulopalatoplasty in patients with ronchopathy and obstructive apnea sleep syndrome. This technique allows to minimize surgical trauma of the tendon-muscle plate during vaporization of pathologically altered soft palate tissues which is confirmed by outcomes after surgery in 309 patients with ronchopathy and obstructive sleep apnea syndrome who were under follow-up observation for 5 years and more.
Results: outcomes after laser sculptural uvulopalatoplasty demonstrate not only complete relief of patients of ronchopathy and obstructive sleep apnea syndrome (result of night snoring) and related complications, but also demonstrate safety and high efficiency (98.4%) of this surgical intervention and stable preservation of the obtained results during 5 years or more after surgery.
Conclusion: laser sculptural uvulopalatoplasty, performed under the careful observation of surgical technique and after careful selection of patients after comprehensive differentiated examination is a safe and effective method for treating patients with ronchopathy and obstructive sleep apnea syndrome. Thus, patients can have stable and complete relief of night snoring and its complications.
About the Authors
V. B. Knyazkov
Rehabilitation Clinic in Khamovniki
Russian Federation
Russian Federation
Moscow
E. N. Prazdnikov
Evdokimov Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
Moscow
N. A. Daikhes
National Medical Research Center for Otorhinolaryngology
Russian Federation
Russian Federation
Moscow
References
1. Buzunov R.V., Palman A.D., Melnikov A.Yu., et al. Diagnosis and treatment of obstructive sleep apnea syndrome in adults. Recommendations of the Russian Society of Somnologists. Effektivnaya farmacoterpia. Nevrologia. 2018; 35: 34–45.
2. Vgontzas A.N., Papanicolaou D.A., Bixler E.O., Lotsikas A., Zachman K., Kales A., Prolo P., Ma-Li Wong, Licinio J., PhiGold P.W., Hermida R.C., Mastorakos G., Chrousos G.P. Circadian Interleukin-6 Secretion andQuantity and Depth of Sleep. The Journal of Clinical Endocrinology & Metabolism. 2000; 84 (8): 2603–2607. PMID: 10443646. DOI: 10.1210/jcem.84.8.5894
3. Stavaras C., Pastaka C., Papala M. et al. Sexual function in pre- and post-menopausal women with obstructive sleep apnea syndrome. Int. J. Impot. Res. 2012; 24 (6): 228–233. DOI: 10.1038/ijir.2012.20
4. Reutrakul S., Zaidi N., Wroblewski K. et al. Interactions between pregnancy, obstructive sleep apnea, and gestational diabetes mellitus. J. Clin. Endocrinol. Metab. 2013; 98 (10): 4195–4202. PMID: 23966237. PMCID: PMC3790617. DOI: 10.1210/jc.2013-2348
5. Fairbanks D.N.F. Uvulopalatopharyngoplasty complications and avoidance strategies. Otolaryngol. Head Neck Surg. 1990; 102: 239–245. PMID: 2108411 DOI: 10.1177/0194599 89010200306
6. Blotsky A.A. The phenomenon of snoring and obstructive sleep apnea syndrome / A.A. Blotsky, M.S. Pluzhnikov. St. Petersburg: SpetsLit, 2002: 176 p.: ill.
7. Friedman M. Z-palatoplasty (ZPP): a technique for patients without tonsils / M. Friedman, H. Ibrahim, R. Vidyasagar, J. Pomeranz, N.J. Joseph. Otolaryngol. Head Neck Surg. 2004; 131: 89–100. PMID: 15243563. DOI: 10.1016/j.otohns.2004.02.051
8. Kamami Y.V. Outpatient treatment of sleep apnea syndrome with CO2 laser, LAUP: laser-assisted UPPP results on 46 patients / YV. Kamami. J Clin Laser Med Surg. 1994; 12 (4): 215–219. PMID: 10172096. DOI: 10.1089/ clm.1994.12.215
9. Remacle M., Betsch C., Lawson G., Jamart J., Eloy P. A new technique for laser assisted uvulo (palato) plasty decisiontree analysis and results. Laryngoscope. 1999; 109: 763– 768. 1999. DOI: 10.1097/00005537-199905000-00015
10. Lopatin A.S., Buzunov R.V., Smushko A.M., Doroshenko N.E., Eroshina V.A. Snoring and obstructive sleep apnea syndrome. Rossiyskaya rhinologia. 1998; 4: 17–33 [In Russ.].
11. Franklin K.A., Hokmgren P.A., Jönsson F. Snoring pregnancy-induced hypertension and growth retardation of the fetus. Chest. 2000; 117 (1): 137–141. PMID: 10631211. DOI: 10.1378/chest.117.1.137
12. Mickelson S.A. Is postoperative intensive care monitoring nesessary after uvulopalatopharyngoplasty? / S.A. Mickelson, I. Hakim. Otolaryngol. Head Neck Surg. 1998; 119: (4): 352– 356. PMID: 9781989. DOI: 10.1016/S0194-5998(98)70077-4
13. Knyazkov V.B., Prazdnikov E.N., Daikhes N.A. Reasons for failure in surgical treatment of patients with ronchopathy and obstructive sleep apnea syndrome. Laser Medicine. 2022; 26 (3–4): 38–46 (In Russ.) DOI: 10.37895/2071-8004-2022- 26-3-4-38-46
14. Kamami Y.V. Laser CO2 for snoring. Preliminary results. Acta Otorhinolaryngol. Belg. 1990; 44 (4): 451–456. PMID: 2128762.
15. Johns M.W. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991; 14 (6): 540–545. PMID: 1798888. DOI: 1.0.1093/sleep/14.6.540
16. Ellis P.D.M. Laser palatoplasty for snoring due to palatal fl utter: a further report. ClinOtolaryngol, 1994; 19 (4): 350–351. PMID: 7994895. DOI: 10.1111/j.1365-2273.1994.tb01245.x
17. Krespy Y.P. Laser-assisted uvulоpalatoplasty for snoring. J. Otolaryngol., 1994; 23: 328–334. PMID: 7807636.
18. Walker R.P. Uvulopalatopharyngoplasty versus laserassisted uvulopalatoplasty for the treatment of obstructive sleep apnea / M.M. Crigg-Damberger, C. Gopalsami. Laryngoscope. 1997; 107(1): 76–82. PMID: 9001269. DOI: 10.1097/00005537-199701000-00016
19. Harmon J.D. Sleep apnea: morbidity and mortality of surgical treatment / J.D. Harmon, W. Morgan, B. Chaudhary. South Med J. 1989, 82 (2): 161–164.
20. Larsson H. Long-time follow-up after UPPP for obstructive sleep apnea syndrome / H. Larsson, B. Carlsson-Nordlander, E. Svanborg. Acta Otolaryngol. 1991; 111 (3): 582–590.
21. Verse T. Laser-assisted uvulopalatoplasty. A metanalysis. In: Fabiani M., Saponara M. (Eds). Surgery for snoring and obstructive sleep apnea syndrome / T. Verse, W. Pirsig. Amsterdam: Kugler; 2003.
22. Littner M. Practice parameters for the use of laser-assisted uvulopalatoplasty: an update for 2000 / M. Littner, C.A. Kushida, K. Hartse, W.M. Anderson, D. Davila, S.F. Johnson, M.S. Wise, M. Hirshkowitz, B.T. Woodson. Sleep. 2001; 24 (5): 603–619. PMID: 11480657. DOI: 10.1093/sleep/24.5.603
23. Knyazkov V.B., Prazdnikov E.N., Stakhanov M.L., Daikhes N.A. The historical aspects and the development of laser palate surgery (a literature review). Lazernaya medicina. 2022; 26(2): 37–42 (In Russ.). DOI: 10.37895/2071-8004-2022-26-2-37-42
24. Knyazkov V.B., Knyazkov I.V., Prazdnikov E.N., Stakhanov M.L. Method of surgical treatment of patients with ronchopathy and obstructive sleep apnea syndrome. RF Patent for invention No. 2760295 dated 12.04.2021. [In Russ.]
25. Knyazkov V.B., Prazdnikov E.N., Stakhanov M.L., Dayhes N.A. Laser sculptural uvulopaltoplasty as a new method of surgical treatment of snoring and obstructive apnea syndrome. Russian Journal of Operative Surgery and Clinical Anatomy. 2023; 7 (1): 5–12. (In Russ.) DOI: 10.17116/operhirurg202370115
26. Knyazkov V.B., Prazdnikov E.N., Daikhes N.A. Selection of patients with rhonchopathy with obstructive sleep apnea syndrome for laser sculptural uvulopalatoplasty / V.B. Knyazkov, E.N. Prazdnikov, N.A. Dykhes // Operative surgery and clinical anatomy. 2023; 7 (2): 19–25. DOI: 10.17116/operhirurg2023702119
27. Fujita S. Surgical correction of anatomical abnormalities of obstructive sleep apnea syndrome: uvulopalatopharyngoplasty / S. Fujita, W. Conway, F. Zorick, T. Rot. Otolaryngol Head Neck Surg. 1981; 89: 923–934.
28. Friedman M. Clinical stading for sleep-disordered breathing / M. Friedman, H. Ibrahim, L. Bass. Otolaryngol. Head Neck Surg. 2002; 127 (1): 13–21.
29. Li H.Y. Changes in quality of life and respiratory disturbance after extended uvulopalatal fl ap Surgery in patients with obstructive sleep apnea / H.Y. Li, N.H. Chen, Y.H. Shu, P.C. Wang. Arch. Otolaryngol. Head Neck Surg. 2004; 130 (2): 195–200.
30. Cahali M.B. Lateral pharyngoplasty: a new treatment for obstructive sleep apneahypopnea syndrome / M.B. Cahali. Laryngoscope. 2003; 113: 1961–1968.
31. Pang K. Expansion sphincter pharyngoplasty: a new technique for the treatment of obstructive sleep apnea / K.P. Pang, B. Woodson. Otolaryngol. Head Neck Surg. 2007; 137: 110–114.
Review
For citations:
Knyazkov V.B., Prazdnikov E.N., Daikhes N.A. Reasonability in performing laser sculptural uvulopalatoplasty in patients with ronchopathy and obstructive sleep apnea syndrome. Laser Medicine. 2023;27(4):26-34. (In Russ.) https://doi.org/10.37895/2071-8004-2023-27-4-26-34
Views:
140
Email this article 