扁桃腺大小與阻塞性睡眠呼吸中止症接受懸雍垂腭咽成型術與扁桃腺切除術的成效
Tonsil Size and Outcome of Uvulopalatopharyngoplasty With Tonsillectomy in Obstructive Sleep Apnea

摘要：

Objectives/Hypothesis: To investigate the relationship of tonsil volume and grade on outcomes of uvulopalatopharyngoplasty (UPPP) with tonsillectomy in patients with obstructive sleep apnea (OSA).

Study Design: Retrospective cohort analysis.

Methods: Data of 70 consecutive patients undergoing UPPP with tonsillectomy between 2015 and 2018 were analyzed. Patients with an apnea-hypopnea index (AHI) <10/hr or concomitant surgery other than nasal surgery were excluded. Tonsil

volume was measured intraoperatively. Preoperatively and 3 months after surgery we assessed the AHI using respiratory polygraphy, daytime sleepiness using the Epworth Sleepiness Scale (ESS), and a visual analog scale for the snoring index (SI).

Results: Tonsil grade and volume both showed a significant correlation with preoperative AHI. Postoperative AHI was not significantly different between grades and volume. The AHI reduction after surgery increased significantly with larger volume

and higher tonsil grade. For all grades, the postoperative ESS was significantly reduced compared to the preoperative value, but was not significantly correlated with tonsil volume. Preoperative and postoperative SI was not significantly correlated

between tonsil grade or volume. In all grades, SI was significantly reduced after surgery.

Conclusions: In our study, we found that large tonsils are responsible for higher preoperative AHI values, and their removal leads to greater reduction of initial AHI. However, the postoperative effect on daytime sleepiness and snoring reduction

is not significantly correlated with tonsil size and volume, indicating that these parameters are mainly influenced by other factors. The knowledge of the significance of tonsil size and volume is important for ear, nose, and throat physicians when

counseling OSA patients.