DISE与模拟咬合在OSA患者非CPAP治疗方式选择中的作用
The role of DISE and simulation bite in the selection of non-CPAP treatment modalities in patients with OSA.
文献信息
| PMID | 42955467 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Sien Cuypers |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, UZ Leuven, Leuven, Belgium. sien.cuypers@student.kuleuven.be. |
| 期刊 | Sleep & breathing = Schlaf & Atmung |
| SCI 分区 | Q3 |
| IF | 2.8 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 本研究旨在探讨药物诱导睡眠内镜（DISE）作为下颌前移矫治器（MRA）、扁桃体切除术和改良悬雍垂腭咽成形术（mUPPP）成功预测因素的作用。此外，评估在DISE期间使用模拟咬合的潜在获益。
方法： 对82例不愿接受或不耐受持续气道正压通气（CPAP）治疗的阻塞性睡眠呼吸暂停（OSA）患者进行回顾性研究。扁桃体较大的患者被建议行扁桃体切除术，并被排除在研究之外。鼻腔病变在可能纳入研究前已接受治疗。所有患者均接受DISE并配合抬颏或模拟咬合，以预测MRA、mUPPP和扁桃体切除术的效果，随后接受治疗后多导睡眠监测（PSG）。
结果： 在被建议开始MRA治疗并接受治疗后PSG的56例患者中，96%获得成功。仅4例患者接受扁桃体切除术，7例接受mUPPP，两者的成功率均较低（分别为50%和29%）。在接受模拟咬合或抬颏DISE的患者之间，MRA成功率无差异。
结论： 本研究证实DISE是MRA成功的极佳预测因素。在扁桃体较小的情况下，mUPPP或扁桃体切除术的成功率远低于MRA，且DISE对这些手术操作成功的预测效果较差。本研究无法证实DISE期间使用模拟咬合的价值。适当应用的抬颏似乎与使用模拟咬合一样能够预测MRA的治疗效果。
英文摘要
PURPOSE: This study aims to investigate the role of drug-induced sleep endoscopy (DISE) as a predictor of success of mandibular repositioning appliances (MRA), tonsillectomy and modified uvulopalatopharyngoplasty (mUPPP). Furthermore, the potential benefit of the use of a simulation bite during DISE is evaluated.
METHODS: A retrospective study was performed on 82 obstructive sleep apnoea (OSA) patients unwilling or not tolerating continuous positive airway pressure (CPAP) treatment. Patients with large tonsils were offered tonsillectomy and were excluded from the study. Nasal pathology was treated before possible inclusion in the study. All patients underwent DISE with chin lift or simulation bite to predict the effect of MRA, mUPPP and tonsillectomy and underwent a post-treatment polysomnography (PSG) afterwards.
RESULTS: Of the 56 patients that were advised to start treatment with MRA and underwent post-treatment PSG, 96% achieved success. Only 4 patients underwent tonsillectomy and 7 underwent mUPPP, both with lower success rates (50% and 29% respectively). There was no difference in success rates of MRA between patients undergoing DISE with simulation bite or chin lift.
CONCLUSION: The study confirms that DISE is an excellent predictor of MRA success. The success rate of mUPPP or tonsillectomy in cases of small tonsils is much lower than that of MRA and DISE is a less effective predictor of success for these surgical procedures.The value of using a simulation bite during DISE cannot be confirmed by this study. An adequately applied chin lift seems to predict the therapeutic effect of MRA as well as the use of a simulation bite.