達文西機械手臂治療睡眠呼吸中止症後味覺相關症狀探討

中山醫學大學機構典藏 CSMUIR > 醫學院 > 醫學研究所 > 博碩士論文 > Item 310902500/20760

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/20760

Title:	達文西機械手臂治療睡眠呼吸中止症後味覺相關症狀探討 The Neural impact about tasting function following of post trans-oral robotic Surgery (TORS) on obstructive sleep apnea syndrome
Authors:	黃新心 Huang, Hsin-Hsin
Contributors:	中山醫學大學:醫學研究所;周明智
Keywords:	經口機械手臂手術;阻塞性睡眠呼吸中止症;夜間多頻道生理檢查儀;懸雍垂;咽成形術 tranoral roboitc surgery 1;obstructive sleep apnea syndrome 2, polysomnography, uvulopalatopharyngoplasty 3
Date:	2019
Issue Date:	2020-07-03T07:58:33Z (UTC)
Abstract:	背景：在睡眠呼吸中止症的外科治療方案中，經口機械手臂手術(TORS)逐漸普及，且表現出色。然而，對於味覺功能障礙的一些術後變化了解甚少，很少有研究涉及這一關鍵問題。手術後患者的味覺結果可以根據需要進一步闡明。本研究的目的是觀察接受TORS的阻塞性睡眠呼吸呼吸中止症 (OSAS)患者的味覺結果，並在基礎醫學證據下思考解決味覺功能障礙的方式。材料和方法：這項前瞻性研究蒐集多頻道生理檢查儀 (PSG)診斷為OSAS的30名患者進行的。研究受試者接受咽顎成形術 (uvulopalatopharyngoplasty, UPPP)與側咽成形術 (lateropharyngoplasty)和TORS舌根 (Tors for Base of tongue)之後，對術前和術後2、3、4周和6個月的受試者進行了主觀式問卷調查。味覺評估包括甜味，酸味，苦味，鹹味，鮮味和金屬味的主觀感覺，以檢測定性味覺障礙。另外，一些患者的舌根外側邊緣的標本也被送到實驗室進行病理分析評估。結果：6個月後，所有患者均未顯示幻味。 90％的受試者表現出恢復正常的甜味，96.6％的受試者在術後6個月顯示酸味恢復正常，93.3％的苦味，90％的鮮味感恢復正常。結論：這項研究表明，在TORS治療OSAS後患者的味覺會產生暫時性的味覺變化。需要更多證據來思考舌根手術範圍。 Background: In the options of surgical treatment for sleep apnea syndrome, transoral roboitc surgery (TORS) gradually became universal and showed its great performance in the recent years. However, some postoperative changes of gustatory dysfunction is poorly understood and very few studies address this crucial problem. This indicates some more elucidation of gustatory outcome for patients after surgery is as far as required. The aim of this study was to follow the gustatory outcome of patients with obstructive sleep apnea syndrome (OSAS) who underwent TORS, and to search the putative mechanism of gustatory dysfunction under the evidence of molecular medicine. Material &Methods: This prospective study was carried out on fifteen patients who were diagnosed as OSAS in accordance with polysomnography (PSG). Study subjects were offered uvulopalatopharyngoplasty (UPPP) with lateral pharyngoplasty and TORS for base of tongue (Tors BOT). Afterwards, some questionnaires for subjects preoperatively and 3,4 weeks and 5 months postoperatively. Taste assessment included subjective sensation of sweet, sour, bitter, salty, umami, spicy and metallic to detect qualitative gustatory disorder. Otherwise, some patients’ specimens of right and left side border of tongue base and inferior portion or bilateral resection tonsil were also sent to laboratory for assessment of pathological analysis. Results: All patient showed no metallic sensation. 90% subjects showed sweet taste back to normal, 96.6% subjects showed sour sensation back to normal and 93.3% of bitter,90% of umami sensation back to normal taste at 6 months postoperatively. In addition, our results also showed different nerve distribution patterns in some specimens. Conclusion: This investigation demonstrated variable gustatory outcomes associated with taste among patients after TORS for OSAS. More basic medical evidence to modify surgical range is necessary.
URI:	https://ir.csmu.edu.tw:8080/ir/handle/310902500/20760
Appears in Collections:	[醫學研究所] 博碩士論文

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