Effect Of Functional Conservation Surgery On Glottic Cancer Patients' Sleep Respiration

Objective:By investigating sleeping quality in preoperative and post-operative patients with glottic carcinoma,we aim to fine how larynx-preserving surgery influence sleeping disorder prospectively to improve patients' living quality after operation.Method:Forty-seven patients who prepared to be treated by functio-preserving surgery with glottic cancer were rolled in this study.The paients underwent sleep apnea monitoring by portable sleep monitor before functio-preserving surgery within a week and removal of tracheostomy tube at least two months afterfunctio-preserving surgery.The patients were divided into two groups by scope of surgery:vertical partial laryngectomy and vertical subtotal larynx excision.The former accounts for twenty-eight and the latter accounts for nineteen.the latter were divided another two groups:radiotherapy groups and non-radiotherapy group,and he former accounts for ten and the latter accounts for nine.Five types of rates were compared:apnea-hypopnea index(AHI),apnea index(AI),hypopnea index(HI),the lowest blood oxygen saturation(LSa O2),the mean blood oxygen saturation(MSa O2).The change of the above five indicators were compared between radiotherapy groups and non-radiotherapy group.Results:1.Among all participants,the rate of moderate to severe OSAHS of post-operation were increased than pro-operation,the differences were statistically significant(P<0.05).the differences of OSASH between post-operation and pro-operation were not statistically significant(P>0.05).2.Among all participants,the AHI and HI of post-operation was increased than pro-operation,the LSa O2 and MSa O2 of post-operation was lower than pro-operation,The differences were statistically significant(P<0.05).the AI of post-operation was lower than pro-operation,The differences were not statistically significant(P>0.05).3.Among the twenty-eight participants who have the vertical partial laryngectomy,the LSa O2 of post-operation was lower than pro-operation,The differences were statistically significant(P<0.05).The AHI,AI and MSa O2 of post-operation was lower than pro-operation,the HI of post-operation was increased than pro-operation,the differences were not statistically significant(P>0.05).4.Among the nineteen participants who have vertical subtotal larynx excision,the AHI and HI was increased than pro-operation,the LSa O2 and MSa O2 was lower than pro-operation,The differences were statistically significant(P<0.05).the AI of post-operation was lower than pro-operation,The differences were not statistically significant(P>0.05).5.Between the two group of vertical subtotal larynx excision and the vertical partial laryngectomy,the differences of the pro-operation index of AHI,AI,HI,LSa O2 and MSa O2 were not statistically significant(P>0.05).the differences of the post-operation,HI was statistically significant(P<0.05),AHI,AI,LSa O2 and MSa O2 were not statistically significant(P>0.05).6.In the group of non-radiotherapy,the AHI of post-operation was increased than pro-operation,the LSa O2 and MSa O2 of post-operation was lower than pro-operation,The differences were statistically significant(P<0.05).the AI,HI of post-operation was lower than pro-operation,The differences of were not statistically significant(P>0.05).7.In the group of radiotherapy,the AHI,AI,HI of post-operation was increased than pro-operation,the LSa O2 of post-operation was lower than pro-operation,The differences were statistically significant(P<0.05).the MSa O2 of post-operation was lower than pro-operation,The differences were not statistically significant(P>0.05).8.The increases of AHI of radiotherapy patients were more than the patients without radiotherapy,The differences were statistically significant(P<0.05).the change of AI,HI,LSa O2 and MSa O2 of radiotherapy patients were not significantly different with the patients without radiotherapy(P<0.05).Conclusion:1.Functio-preserving surgery to patients with glottic cancer influence the respiratory condition,and the scope of surgery and radiotherapy were key factors.2.It has small impact on sleep breathing obstruction of vertical subtotal larynx excision,and great impact of vertical subtotal larynx excision.3.Surgery and radiotherapy make sleep apnea hypopnea more serious than simple operation.4.Monitoring of sleep breathing should be one of assessment after functio-preserving surgery.