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Yıl:2017; Cilt: 4; Sayı: 1>> Özet
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Türk Uyku Tıbbı Dergisi; 2017;4(1):6-15
Uvulopalatal Flap Cerrahisi Etkinliğinin Nicel Analizi
A Erdamar, T Bayrak, H Fırat, M Mutlu, S Ardıç, O Eroğul
Başkent Üniversitesi, Ankara
Amaç: Bu çalışmada, uvulopalatal flap cerrahisinin kantitatif analizi için sinyal işleme tekniklerine dayanan yeni bir metodoloji önerilmektedir. Uvulopalatal flap ameliyatı ile ilgili klinik değerlendirme çalışmaları, doktorların muayenesine bağlı olmakla birlikte, hastanın subjektif geribildirimini de içermektedir. Kantitatif ve objektif değerlendirme çalışması literatürde halen eksiktir. Gereç ve Yöntem: Ameliyat öncesinde ve sonrasında 21 hastanın tüm gece uyku kayıtları analiz edilmiştir. Önerilen algoritma, iki bağımsız bölümden oluşmaktadır. Birinci bölümde, kalp hızı değişkenliği ve elektrokardiyogramın karmaşıklığı hesaplanmıştır. İkinci bölüm ise, elektroensefalogram alt bantlarının enerjilerinin hesaplanmasını içerir. Ardından, klinik ve deneysel parametreler arasındaki ilintinin belirlenmesi için istatistiksel yöntemler uygulanmıştır. Bulgular: Düşük frekans/yüksek frekans oranı ve beta dalgasının alt bant enerjisi, ameliyat sonrası delta uyku süresi düşük olan hastalar için anlamlıdır. Ayrıca, hem ameliyat sonrası delta uyku süresi hem de kan gazında ölçülen O2 satürasyonu (SaO2) parametresi yüksek olanlar için alfa ve beta dalgalarının ve teta dalgasının alt bant enerjileri anlamlıdır. Ameliyat sonrası solunum bozukluğu endeksi ve SaO2 parametresi düşük olan hastalarda karmaşıklık anlamlıdır ve solunum bozukluğunun horlama indeksi ile ilintisi bulunmaktadır. Sonuç: Ameliyat öncesi ve sonrasındaki klinik bulgulara göre anlamlı olmayan solunum bozukluğu indeksinin karmaşıklık özelliği ile doğrudan ilişkili olduğu bulunmuştur. Bu çalışmanın en önemli sonucu, ameliyat öncesi karmaşıklık özelliğinin solunum bozukluğu ve horlama indeksi ile ilintili olmasıdır. Bu, karmaşıklık özelliğinin cerrahiden önce bir öngörü parametresi olabileceği anlamına gelmektedir.
The Quantitative Analysis of Uvulopalatal Flap Surgery
Objective: In this work, a new methodology based on signal processing techniques for the quantitative analysis of uvulopalatal flap surgery is proposed. Clinical assessment studies of uvulopalatal flap surgery are based on not only the physician’s examination, but also the patient’s subjective feedback. Quantitative and objective evaluation studies are still lacking in the literature. Materials and Methods: Full night sleep records were analyzed for 21 patients before and after the surgery. The proposed algorithm consists of two independent parts. In the first part, the heart rate variability and complexity of the electrocardiogram were calculated. The second part includes calculating the electroencephalogram sub-band energy. Afterwards, the statistical methods were applied in order to determine the correlation of clinical and experimental parameters. Results: The low frequency/high frequency ratio and the sub-band energy of beta wave were significant for the patients having low postoperative delta sleep duration. Moreover, the sub-band energies of both alpha and beta waves, and theta wave were significant for the patients who had high post-operative delta sleep duration and blood oxygen saturation (SaO2)-parameter. Complexity was significant for the patients with low postoperative respiratory disturbance index and SaO2 parameter, and respiratory disturbance is correlated with snoring index. Conclusion: Respiratory disturbance index, which is not significant according to the pre- and post-operative clinical findings, was found to be directly related to the complexity feature. The most important result of this work is that the pre-operative complexity feature is correlated with respiratory disturbance and snoring index. This means that complexity feature can be a predictor prior to surgery.

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