Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (4): 124-130.doi: 10.6040/j.issn.1673-3770.0.2018.517

Previous Articles     Next Articles

Soft palate surgeries with hyoid bone suspension for obstructive sleep apnea hypopnea syndrome with glossoptosis: a meta-analysis

JI Di,CHEN Xiang, YU Lin   

  1. Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
  • Online:2019-07-20 Published:2019-07-22

PDF (PC)

346

Abstract: Objective To assess the efficacy of soft palate surgeries with hyoid bone suspension for obstructive sleep apnea syndrome(OSAS)with both obstructions of palatopharyngeal plane and hyopharyngeal planes obstructions. Methods An electronic search was conducted on the VIP, CNKI, and Pubmed databases and several studies were selected according to the inclusion and exclusion criteria. Subsequently, the literature quality was evaluated by MINORS and data were extracted to perform qualitative description. Data about effects were meta-analyzed by RevMan 5.3. Results A total of 13 self-controlled trials or RCTs involving 310 patients were included in the present meta-analysis. All the patients presented moderate to severe OSAHS and were followed up for more than 3 months following the surgeries. Most of the trials were self-controlled, whereas two of them were RCTs. According to the MINORS, while two studies represented a low quality research(0-12 points in total), two reported a high quality(19-24 points in total), whereas the remaining nine studies were characterized by a moderate quality(13-18 points in total). Of the 11 studies contrasting the apnea hypopnea index(AHI), 2 were asymmetric at the bottom of the funnel plots, suggesting a publication bias. Furthermore, 2 studies contrasting the respiratory disturbance index(RDI)were present, whereas 13 investigations contrasting the lowest arterial oxygen saturation(LSaO2)were found. Of them, 4 were asymmetric at the bottom of the funnel plots, indicating a publication bias. The meta-analyses described a significant improvement in AHI, RDI, LSaO2, AHI 45.61,95% CI(42.48,48.73),P<0. 001,RDI 35.26,95% CI(22.47,48.04),P<0.001,LSaO2-20.16,95% CI(-24.99,-15.33),P<0.001. A significant heterogeneity was observed in the meta-analysis, while the sensitivity analysis indicated Lin Ling’s result to be the cause. Conclusion Although most studies are moderate quality self-controlled trials, a larger sample size is needed. Soft palate surgeries with hyoid bone suspension are effective in reducing AHI and RDI and enhancing LSaO2, even though additional evidences are warranted to validate their effects.

Key words: Obstructive sleep apnea syndrome, Hyoid bone suspension, Meta-analysis

CLC Number: 

  • R766.7
[1] 黄选兆,汪吉宝,孔维佳.实用耳鼻咽喉头颈外科学[M].2版.北京:人民卫生出版社,2011:375.
[2] 王卫之,王岩,王欣,等.舌骨悬吊术在阻塞性睡眠呼吸暂停低通气综合征中的应用[J].临床耳鼻咽喉科杂志,2005,19(21):978-980.doi: 10.3969/j.issn.1001-1781.2005.21.007. WANG Weizhi, WANG Yan, WANG Xin, et al. Application of hyoid suspension in obstructive sleep apnea-hypopnea syndrome[J]. J Clin Otorhinolaryngol, 2005,19(21):978-980.doi: 10.3969/j.issn.1001-1781.2005.21.007.
[3] Sher AE, Schechtman KB, Piccirillo JF. The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome[J].Sleep, 1996,19(2):156-177.doi: 10.1093/sleep/19.2.156
[4] Slim K, Nini E, Forestier D, et al. Methodological index for non-randomized studies(minors): development and validation of a new instrument[J]. ANZ J Surg, 2003,73(9):712-716. doi: 10.1046/j.1445-2197.2003.02748.x
[5] Neruntarat C. Hyoid myotomy with suspension under local anesthesia for obstructive sleep apnea syndrome[J]. Eur Arch Otorhinolaryngol, 2003,260(5):286-290. doi: 10.1007/s00405-002-0560-0.
[6] 姚行齐,褚勇,孙艺,等.舌骨悬吊术治疗重度阻塞性睡眠呼吸暂停低通气综合征34例[J].临床耳鼻咽喉科杂志, 2005,19(3):132-133.doi:10.3969/j.issn.1001-1781.2005.03.014. YAO Xingqi, ZHU Yong, SUN Yi, et al. Hyoid suspension was used to treat 34 cases of severe obstructive sleep apnea hypopnea syndrome[J]. J Clin Otorhinolaryngol, 2005,19(3):132-133. doi:10.3969/j.issn.1001-1781.2005.03.014.
[7] 张庆泉,宋西成,张华,等.舌骨悬吊联合悬雍垂腭咽成型术治疗重症阻塞性睡眠呼吸暂停低通气综合征[J]. 山东大学耳鼻喉眼学报, 2006,20(3):201-203.doi: 10.3969/j.issn.1673-3770.2006.03.003. ZHANG Qingquan, SONG Xicheng, ZHANG Hua, et al. Hyoid suspension and uvolopalatopharyngoplasty in treatment of severe obstructive sleep apnea hypopnea syndrome[J]. J Otolaryngol Ophthalmol Shandong Univ, 2006, 20(3):201-203. doi: 10.3969/j.issn.1673-3770.2006.03.003.
[8] 杜国平,李永德.Repose系统舌骨悬吊术结合腭垂腭咽成形术对重度OSAHS合并2型糖尿病患者血糖影响的中长期比较研究[J]. 医学研究杂志, 2014,43(4):167-170. DU Guoping, LI Yongde. Long-term comparative study on the effect of repose hyoid suspension system combined with UPPP surgery on patients' blood glucose with severe OSAHS and type 2 diabetes[J]. J Med Res, 2014,43(4):167-170.
[9] 盛建飞,罗志宏,孔勇刚,等.Repose系统舌骨悬吊结合悬雍垂腭咽成形术手术治疗重度阻塞性睡眠呼吸暂停低通气综合征近期疗效观察[J]. 临床耳鼻咽喉头颈外科杂志, 2007,21(24):1127-1128.doi: 10.3969/j.issn.1001-1781.2007.24.007. SHENG Jianfei, LUO Zhihong, KONG Yonggang, et al. Hyoid suspension with repose system combined with UPPP in severe OSAHS patients:short-term results[J]. J Clin Otorhinolaryngol Head Neck Surg, 2007,21(24):1127-1128. doi: 10.3969/j.issn.1001-1781.2007.24.007.
[10] 马胜.离子刀腭咽成形术联合舌骨悬吊术治疗重度阻塞性睡眠呼吸暂停综合征36例[J]. 陕西医学杂志, 2008,37(10):1335-1337. doi:10.3969/j.issn.1000-7377.2008.10.027. MA Sheng. Hyoid suspension plus coblation assisted uvulopalatopharyngoplasty for severe OSAHS: a report of 36 cases[J]. Shaanxi Medical Journal, 2008,37(10): 1335-1337. doi:10.3969/j.issn.1000-7377.2008.10.027.
[11] 王永福.舌骨悬吊联合腭咽成形术治疗阻塞性睡眠呼吸暂停低通气综合征的临床研究[D]. 青岛:青岛大学,2008.
[12] 林凌,袁琨,张琼,等.舌骨悬吊结合悬雍垂腭咽成形术与单纯悬雍垂腭咽成形术治疗OSAHS患者疗效比较[J]. 现代中西医结合杂志, 2010,19(17):2108-2109.doi: 10.3969/j.issn.1008-8849.2010.17.013. LIN Ling, YUAN Kun, ZHANG Qiong, et al. Comparison of efficacy between hyoid suspension combined with uvulopalatopharyngoplasty and simple uvulopalatopharyngoplasty for OSAHS patients[J]. Modern J Integrated Tradit Chin Western Med, 2010,19(17):2108-2109. doi: 10.3969/j.issn.1008-8849.2010.17.013.
[13] 陈盈,洪晓林.舌骨悬吊术联合UPPP治疗9例OSAHS疗效分析[J]. 贵州医药, 2012,36(6):523-524. CHEN Ying, HONG Xiaolin. Effect analysis of hyoid suspension combined with UPPP in treatment of 9 OSAHS patients[J]. Guizhou Medical Journal, 2012,36(6):523-524. doi: 10.3969/j.ISSN.1000-744X.2012.06.015
[14] 赵昕.OSAHS舌骨悬吊手术舌骨位置及舌后间隙变化与疗效的关系[D]. 青岛:青岛大学,2012.
[15] 刘三印.观察舌骨甲状软骨悬吊术联合改良咽侧成形术应用于阻塞性睡眠呼吸暂停低通气综合征的治疗效果[J]. 中国医药指南, 2014,12(6):20-22. LIU Sanyin. Contrast observe the therapeutic effect of the lateral pharyngeal angioplasty joint hyoid thyroid cartilage suspension surgery and the lateral pharyngeal angioplasty are applied to the obstructive sleep apnea hypopnea syndrome[J]. Guide China Medicine, 2014,12(6):20-22.
[16] Tantawy AA, Askar SM, Amer HS, et al. Hyoid Bone Suspension as a Part of Multilevel Surgery for Obstructive Sleep Apnea Syndrome[J]. Int Arch Otorhinolaryngol, 2018, 22(3): 266-270.
[17] 吴允刚, 张辉, 庞太忠,等.同期悬雍垂腭咽成形术联合舌骨悬吊术治疗重度阻塞性睡眠呼吸暂停低通气综合征的疗效观察[J]. 临床耳鼻咽喉头颈外科杂志, 2014,28(24):1972-1974. WU Yungang, ZHANG Hui, PANG Taizhong, et al. Uvulopalatopharyngoplasty and hyoid suspension for obstructive sleep apnea hyponea syndrome[J]. J Clin Otorhinolaryngol Head Neck Surg, 2014,28(24):1972-1974. doi: 10.13201/j.issn.1001-1791.2014.24.018.
[18] 孙岩, 张庆泉, 宋西成,等.舌骨悬吊手术的并发症[J]. 山东大学耳鼻喉眼学报, 2008,22(5): 393-394,397. SUN Yan, ZHANG Qingquan, SONG Xicheng, et al. Complications following hyoid suspension[J]. J Otolaryngol Ophthalmol Shandong Univ, 2008,22(5):393-394,397.
[19] 李平.腭咽成形术联合舌骨悬吊术后并发急性肠系膜上静脉血栓形成1例(附文献复习)[J]. 山东大学耳鼻喉眼学报, 2012,26(3):5-6,9. LI Ping. Acute superior mesenteric venous thrombosis after UPPP combined with hyoid suspension surgery( case report with literature review)[J]. J Otolaryngol Ophthalmol Shandong Univ, 2012, 26(3):5-6,9. doi: 10.6040/j.issn.1673-3770.2012.03.003.
[20] Hou T, Shao J, Fang S. The definition of the V zone for the safety space of functional surgery of the tongue[J]. Laryngoscope, 2012, 122(1):66-70. doi: 10.1002/lary.22342.
[21] Friedman M, Hamilton C, Samuelson CG, et al.Transoral robotic glossectomy for the treatment of obstructive sleep apnea-hypopnea syndrome[J]. Otolaryngol Head Neck Surg, 2012,146(5):854-862. doi: 10.1177/0194599811434262
[22] Lin HS, Rowley JA, Badr MS, et al.Transoral robotic surgery for treatment of obstructive sleep apnea-hypopnea syndrome[J]. Laryngoscope, 2013,123(7): 1811-1816. doi: 10.1002/lary.23913.
[23] 温伟生,胡敏,王照五,等.UPPP、颏前徙术及舌骨悬吊术对OSAS患者上气道影响的初步分析[J]. 口腔颌面外科杂志, 2004,14(3):237-239. WEN Weisheng, HU Min, WANG Zhaowu, et al. The effect of methods of surgical treatment in obstructive sleep apnea[J]. J Oral Maxillofac Surg, 2004,14(3):237-239. doi: 10.3969/j.issn.1005-4979.2004.03.013.
[24] 王永福,张庆泉,张杰,等.舌骨悬吊联合腭咽成形术前后舌咽平面X线头影测量[J]. 山东大学耳鼻喉眼学报, 2008,22(2):112-114. WANG Yongfu, ZHANG Qingquan, ZHANG Jie, et al. An analysis of the pre-operative and post-operative X-ray projection of patients with hyoid suspension and uvolopalatopharyngoplasty surgery[J]. J Otolaryngol Ophthalmol Shandong Univ, 2008,22(2):112-114.
[25] Stuck BA, Neff W, Hormann K, et al. Anatomic changes after hyoid suspension for obstructive sleep apnea: an MRI study[J]. Otolaryngol Head Neck Surg,2005,133(3):397-402. doi:10.1016/j.otohns.2005.06.002.
[26] 张湘民. 阻塞性睡眠呼吸暂停低通气综合征定位诊断之惑[J]. 山东大学耳鼻喉眼学报, 2017,31(1):4-7,17.doi:10.6040/j.issn.1673-3770.0.2017.007. ZHANG Xiangmin. Localization diagnosis of obstructive sleep apnea hypopnea syndrome[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2017,31(1):4-7,17.doi:10.6040/j.issn.1673-3770.0.2017.007.
[1] FANG Lu, LEI Yudan, WANG Hua. Meta-analysis of clinical effect of cyclosporine eye drops in combination with sodium hyaluronate eye drops in the treatment of dry eye syndrome [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(2): 65-73.
[2] LEI Yudan, FANG Lu, CHEN Jian, PENG Changfu. Meta-analysis of clinical Efficacy of tocilizumab in the treatment of moderate-to-severe thyroid-associated ophthalmopathy with steroid resistance or intolerance [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 54-67.
[3] XU Xuemeng, FAN Lei, YU Wangbo, JIANG Zhiyue, PAN Chen, HUANG Yongqin. Meta-analysis of the efficacy of omalizumab in combination with specific immunotherapy for allergic rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(5): 26-33.
[4] SUN Chunxiao, WANG Wenqing, YUE Tian, LIU Jisheng. Efficacy analysis of concurrent chemoradiotherapy with high and low cumulative cisplatin doses in the treatment of nasopharyngeal carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 31-41.
[5] ZHENG Zehao, WEI Jiali, LIU Jiatao, ZHOU Yuqi, SUN Wenting, LI Yuxuan, BAI Peng. Evaluation of the efficacy and safety of site-specific acupuncture for the treatment of sudden hearing loss: a systematic review and network Meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 114-127.
[6] MI Xueqin, LI Songzhe, DENG Yingjie, LI Shengyang, XIAO Dingqi, FAN Lei. Meta-analysis of the clinical efficacy and safety of proton pump inhibitors versus gastric mucosal protective agents in the treatment of laryngopharyngeal reflux disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(6): 136-142.
[7] ZHAO Yun, TENG Zhipan, LI Qi, SHEN Xiaofei. Twenty-six cases of tubal torus hyperplasia after adenoid tonsillectomy in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(3): 43-48.
[8] WANG Kaijian, CHEN Xuesheng, WANG Wei. A meta-analysis of the correlation between platelet-lymphocyte ratio and prognosis of laryngeal squamous cell carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(3): 67-73.
[9] LI Yang, LIU Dong, CAO Wenjie. Meta-analysis of the effect of red-light therapy on spherical equivalent, axial length, and choroidal thickness in myopic children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(3): 74-81.
[10] ZHANG Zhen, YANG Zhuoying, ZHOU Jiani, ZHANG Dawei, CHEN Renjie. Efficacy and safety of ciclesonide nasal spray in the treatment of seasonal allergic rhinitis:a Meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(1): 13-20.
[11] WANG Teng, YU Lin, LI Sui. The correlation between γ-glutamyl transferase and obstructive sleep apnea syndrome-related hypertension [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 80-84.
[12] ZHANG Yuhuan, ZHANG Junbo, YIN Guoping, YUAN Xuemei, CAO Xin, SUN Yu, CHEN Qiang, YE Jingying. Comparative analysis of polysomnography parameters between the first and second halves of the night in snoring patients [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 112-117.
[13] BI Xiaoyun, MA Benxu, WANG Xinru, LI Xuhao, YANG Jiguo. Meta-analysis of randomized controlled trials of acupoint application in treatment of children with allergic rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(4): 75-85.
[14] LI Zepeng, LI Wenjian, SUN Zhijia. Net Meta-analysis and data mining of patients with acute pharyngitis managed with Chinese medicine [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(4): 111-118.
[15] ZHAI Rui, LI Yuan, YU Jinglong, CHEN Xi, ZHENG Youyou, LIU Zhaolan, WANG Junhong. Meta-analysis of clinical intradermal acupuncture efficacy for treatment of allergic rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(3): 35-45.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd