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Abstract(s)
A SAOS caracteriza-se por episódios intermitentes e recorrentes de
apneias/hipopneias, resultantes de um colapso da via aérea superior durante o
sono, o que leva a períodos de hipoxemia e hipercapnia que, por sua vez,
conduzem a uma ativação reflexa do sistema nervoso simpático, provocando o
despertar.
O papel das opções cirúrgicas para o tratamento de SAOS é muito controverso.
A SAOS trata-se de uma patologia com perfil multifatorial, o que a converte num
desafio multidisciplinar, tanto do ponto de vista diagnóstico, como no que se
refere ao seu tratamento. Os utentes, se selecionados de modo criterioso, podem
beneficiar da aplicação de determinado procedimento cirúrgico, sendo que os
principais objetivos para a sua aplicação passam por aumentar o volume da VAS
e/ou remover locais de obstrução da mesma.
Vários procedimentos foram propostos ao longo de vários anos de
investigação, tendo alguns caído em desuso, enquanto outros se foram afirmando
cada vez mais como uma potencial opção terapêutica para a SAOS.
Neste trabalho serão descritas as principais opções cirúrgicas disponíveis para
o tratamento de SAOS, os benefícios e riscos que acarretam, bem como o
resultado cirúrgico que se espera obter, tendo em conta a informação disponível
atualmente na literatura médica.
Embora a cirurgia não seja o tratamento adequado para todos os utentes com
SAOS, dependendo da finalidade do procedimento em consideração, alguns
grupos de utentes poderão beneficiar da sua aplicação. No entanto, são
necessários mais estudos que permitam avaliar os riscos e resultados obtidos com
a aplicação destes procedimentos e é necessário investir em formas de perceber
quais os locais de obstrução presentes numa determinada VAS, antes de decidir
qual a melhor abordagem a aplicar.
OSAS is characterized by intermittent and recurrent episodes of apneas/hypopneas, resulting from a collapse of the upper airway during sleep, which leads to periods of hypoxemia and hypercapnia which, in turn, lead to a reflex activation of the sympathetic nervous system, causing awakening. The role of surgical options for the treatment of OSAS is highly controversial. OSAS is a pathology with a multifactorial profile, which makes it a multidisciplinary challenge, both in terms of diagnosis and treatment. Patients, if carefully selected, can benefit from the application of a certain surgical procedure, and the main objectives for its application are to increase the volume of the upper airway and/or remove obstruction sites. Various procedures have been proposed over several years of research, some of which have fallen into disuse, while others have increasingly become a potential therapeutic option for OSAS. This paper will describe the main surgical options available for the treatment of OSAS and their benefits and risks, as well as the expected surgical outcome, taking into account the information currently available in the medical literature. Although surgery is not the right treatment for all patients with OSAS, depending on the purpose of the procedure under consideration, some groups of patients may benefit from it. However, more studies are needed to assess the risks and results obtained from applying these procedures, and we need to invest in ways of understanding which obstruction sites are present in a given upper airway before deciding on the best approach to apply.
OSAS is characterized by intermittent and recurrent episodes of apneas/hypopneas, resulting from a collapse of the upper airway during sleep, which leads to periods of hypoxemia and hypercapnia which, in turn, lead to a reflex activation of the sympathetic nervous system, causing awakening. The role of surgical options for the treatment of OSAS is highly controversial. OSAS is a pathology with a multifactorial profile, which makes it a multidisciplinary challenge, both in terms of diagnosis and treatment. Patients, if carefully selected, can benefit from the application of a certain surgical procedure, and the main objectives for its application are to increase the volume of the upper airway and/or remove obstruction sites. Various procedures have been proposed over several years of research, some of which have fallen into disuse, while others have increasingly become a potential therapeutic option for OSAS. This paper will describe the main surgical options available for the treatment of OSAS and their benefits and risks, as well as the expected surgical outcome, taking into account the information currently available in the medical literature. Although surgery is not the right treatment for all patients with OSAS, depending on the purpose of the procedure under consideration, some groups of patients may benefit from it. However, more studies are needed to assess the risks and results obtained from applying these procedures, and we need to invest in ways of understanding which obstruction sites are present in a given upper airway before deciding on the best approach to apply.
Description
Keywords
Apneia Obstrutiva do Sono Cirurgia Distúrbio Respiratório