著者

HORMANN Karl ALEXANDER Baisch

出版者

日本口腔・咽頭科学会

雑誌

口腔・咽頭科 = Stomato-pharyngology (ISSN:09175105)

巻号頁・発行日

vol.17, no.2, pp.231-238, 2004-12-10

参考文献数

40

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Obstructive sleep apnea (OSA) is characterized by nocturnal collapsing of the upper airways. Consequently complete cessation of breathing or reduced breathing phases appears. OSA is a widespread disorder affecting up to 11% of the male and up to 6 % of the female population. It is associated with serious consequences such as myocardial infarction, stroke, hypertension and traffic accidents. Nasal continuous positive airway pressure (nCPAP) ventilation is the gold standard in the treatment of obstructive sleep apnea syndrome (OSAS). Long-term compliance rates do not exceed more than 60 to 70 %. Other options like surgical procedure exist. But only one surgical procedure won't be successful in cases of moderate and severe OSA because one surgery will enlarge the airway only at one location. Alternative multi-level surgeries are of interest, combining procedures at the level of the base of tongue and the soft palate in order to stabilize the whole upper airway like the CPAP-ventilation. Several multi-level surgery concepts exist. Our multi-level surgery based on the hyoid suspension with the combination of a radiofrequency therapy of the tongue base brings out the effectiveness of this concept. With this concept we achieve a success rate of 57.6 %; this result situates us at the average level of the cited multi-level surgery studies. With this success rate this protocol can replace the CPAP mask especially in cases with CPAP intolerance or decline