2016 Volume 59 Issue 2 Pages 85-92
The patient, a 36-year-old woman, was diagnosed as having moderate OSA (AHI=29.7/hr) by polysomnography. She was started on nasal continuous positive airways pressure (nCPAP) treatment, however, she could not tolerate the assisted ventilation, and desired surgical cure. We proposed two-phase surgery for her, however, she did not hope MMA. Finally, we planned nasal surgery, pharyngeal surgery and genioglossal advancement (GA) at the same time, because she had hypogrowth of the mentum.
After the surgery, the AHI decreased from 29.7/hr to 4.9/hr. Also, a postoperative CT evaluation revealed transverse expansion of the pharynx.
Two-phase surgery, including soft-tissue surgery (nasal, pharyngeal) and skeletal surgery (MMA), proposed by Stanford University, has recently come to be recognized as a treatment option for OSA. However, some patients still do not wish to undergo two-phase surgery, including invasive surgery such as MMA, in Japan. GA is useful for OSA patients with hypogrowth of the mentum and can be accomplished by soft-tissue surgery as one-time surgery. It is necessary to clarify the factors responsible for the OSA in each patient correctly, and select the appropriate surgical method to eliminate the responsible factor.
