Therapeutic Effect Of Coblation-assisting Uvulopalatophary Combining Coblation-channeling For The Tongue For Patients With OSAHS

Objective:To investigate the effect of Ca-uvulopalatophary(Ca-UPPP)combined with coblation-channeling for the tongue(CCT)on OSAHS and difference inthe curative effect between patients with hypertrophy of tongue ? degree and patie nts with hypertrophy of tongue IV degree through retrospective analysis ofpatient s with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods:196 patients with OSAHS diagnosed by PSG in our department from October 2016 to May 2018 were collected as subjects(aged from 28 to 59 years old,average 40.53±5.12 years old,180 males and 16 females).Nasal CT examination was needed to exclude nasal and nasopharyngeal stenosis before operation.Sagittal CT examination of tongue and Mullar test under electronic nasoscope were performed to identify the stenosis.Surgical contraindications except hypothyroidism,pituitary adenoma,routine biochemical,imaging and electrocardiogram examination were excluded.All patients were divided into two groups according to the operation methods:168 patients underwent coblation-assisting uvulopalatophary combining coblation-channeling for the tongue(CCT group),28 patients underwent Ca-uvulopalatophary(uvulopalatophary group).According to Friedman tongue classification,patients in tongue perforation group were examined before operation(grade I:patients open their mouths,tongue body did not obviously occlude the whole oropharyngeal cavity;grade ?:palatal tonsil could not be seen;grade ?:tongue body covered the plane below uvula;grade ?:only hard palate could be seen).The patients were divided into two groups:group A,62 patients with tongue of grade ?,group B,106 patients with the tongue of grade IV.The operation time(min),bleeding volume(ml),degree of pain and length of hospitalization(days)were counted.The changes of AHI,SaO2 and LSaO2 were compared before and after operation.The curative effect was determined by calculating the effective rate.The quality of life scale and ESS scale were used to observe the similarities and differences of psychological and sleepiness symptoms.Result:There were no significant differences in the time of operation,blood loss,postoperative pain,and hospital stay between tongue perforation group and uvulopalatophary group(P>0.05).There were significant differences in the effective rate?AHI?SaO2?LSaO2?quality of life scale?sleepiness symptoms between tongue perforation group and uvulopalatophary group(P<0.05)but no differences between group A and Group B(P>0.05).Conclusion:1.Ca-UPPP combined with CCT is more effective than Ca-UPPP alone in OSAHS.It can significantly expand the cross-sectional area of posterior lingual airway,and relieve the stenosis of posterior lingual airway.It is an effective surgical method and worth popularizing in clinic.2.Compared with Ca-UPPP,Ca-UPPP combined with CCT can better improve sleepiness symptoms and mental health of patients.3.Ca-UPPP combined with CCT has no difference in the curative effect between patients with hypertrophy of tongue III degree and patients with hypertrophy of tongue IV degree.