Applied Research Of Modified Tracheotomy Assisted By Laryngeal Mask In The Multi-plane Surgery For Severe Obstructive Sleep Apnea Hypopnea Syndrome

Objective To explore the clinical value of modified tracheotomy assisted by laryngeal mask in the multi-plane surgery under general anesthesia for patients with severe obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A retrospective review was made among 24 cases with severe OSAHS treated by a concurrent multi-plane surgery under the condition of modified tracheotomy assisted by laryngeal mask with general anesthesia,performed during recent 6 years,with their clinical data reviewed carefully. General anesthesia was carried out by inserting laryngeal mask through mouth at first, and then,modified tracheotomy was performed via a transverse incision,followed by pulling out laryngeal mask and inserting endotracheal tube through tracheal stoma.After this procedure,a multiple plane operation was done under such a condition to treat severe OSAHS concurrently. These included one case of nasal surgery expansion and uvulopalatopharyngoplasty and tongue base reduction,seven cases of nasal surgery expansion and uvulopalatopharyngoplasty and tongue plasma radiofrequency,three cases of nasal surgery expansion and uvulopalatopharyngoplasty and tongue suspension,two cases of nasal surgery expansion and tonsillectomy and uvulopalatopharyngoplasty and hyoid suspension surgery,five cases of nasal surgery expansion and tonsillectomy and uvulopalatopharyngoplasty and tongue plasma radiofrequency,six cases of nasal surgery expansion and tonsillectomy and uvulopalatopharyngoplasty.Results All the patients were sent back to the general ward instead of ICU after the operation,with no major operation-associated complications occurred during the period of hospital stay.Tracheal tube was pulled out successfully among these cases within 7 to 30 days.Among them, 3 cases with mild subcutaneous emphysema were found, but they were cured after 4 to 6 days with no special treatment.By the end of following up periodlasted for 6 months,all patients were satisfied with their surgery and rehabilitation efficacy.Conclusion Modified tracheotomy assisted by laryngeal mask is easy to perform,with few complications occurring and inconspicuous postoperative scar in the region of incision.Such a procedure may ensure the concurrent multi-plane operation on cases with severe OSAHS performed safely as possible as it can.