Makaryna-Kibak L.E.1, Yaromenka Y.E.1, Кarnialiuk V.A.1, Mirylenka А.P.2
Determining the criterion of the unfavourable course of the postoperative period in patients with oropharyngeal level of obstruction
1Republican Scientific and Practical Centre of Otorhinolaryngology, Minsk, Republic of Belarus
2Belarusian State Agrarian Technical University, Minsk, Republic of Belarus
Vestnik VGMU. 2018;17(6):100-105.
As a result of the study performed, an integral criterion of the postoperative period course has been developed, which is the sum of negative factors: bleeding, suture line disruption, excessive scarring, рain according to visual-analogue scale on the 7th day>4 points, mucosal edema on the 7th day>1 point according to 3-point visual-analogue scale. The sum of the points for these factors is an integral criterion [S], characterizing the degree of an unfavourable course of the postoperative period. When the values of this criterion equal S>2, the course of the postoperative period should be considered as an unfavourable one. The presence of an integral dichotomous criterion will allow to develop a mathematical model for prognosticating the course of the postoperative period.
A group with the unfavourable course of the postoperative period has been identified in which the probability of the complications is significantly higher in comparison with the main group: suture line disruption – 6,5 times (85% vs. 13%), bleeding –14 times (69% vs. 5%), excessive and coarse scarring –31 times (62% vs. 2%) (p<0,001). The duration median of an inpatient treatment in the group with the unfavourable course of the postoperative period made up 12 bed-days (interquartile range 8-13) vs. 7,5 bed-days in the main group (interquartile range 7-8). The duration of the soft palate and tonsillar niches cleansing in the group with the unfavourable course was 15 days (interquartile range 13-17) compared to the favourable course group where it was 12 days (interquartile range 10-16) (p<0,001).
Key words: obstructive sleep apnea syndrome, postoperative period, integral criterion, poor prognosis.
1. Kolyadich ZhV. Analysis of diagnostic significance of upper respiratory endoscopic examination in patients with obstructive sleep apnea syndrome. Ros Otorinolaringologiia. 2014;(6):57-61. (In Russ.)
2. Ovechkin AM, Politov ME. Postoperative analgesia in terms of evidence-based medicine. Vestn Intensiv Terapii. 2016;(2):51-60. (In Russ.)
3. Aksoy EA, Serin GM, Polat S, Ünal ÖF, Tanyeri H. Comparison of postoperative bleeding between submucosal uvulopalatopharyngoplasty and tonsillectomy. J Res Med Sci. 2014 Apr;19(4):310-3.
4. Yang G, Cun L, Ma Y, Duan J. Analysis of bleeding cause after uvulopalatopharyngoplasty with endotherm knife. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Oct;29(19):1710-2.
5. Kim JA, Lee JJ, Jung HH. Predictive factors of immediate postoperative complications after uvulopalatopharyngoplasty. Laryngoscope. 2005 Oct;115(10):1837-40. doi: http://dx.doi.org/10.1097/01.mlg.0000173199.57456.2b
6. Huskisson EC. Measurement of pain. Lancet. 1974 Nov;2(7889):1127-31.
7. Svistushkin VM, Nikiforova GN, Dedova MG, Shevchik EA. Postoperative optimization in patients with chronic tonsillitis. Rus Med Zhurn. 2015;23(6):326-31. (In Russ.)
Information about authors:
Makaryna-Kibak L.E. – Doctor of Medical Sciences, associate professor, Republican Scientific and Practical Centre of Otorhinolaryngology;
Yaromenka Y.E. – Doctor of Medical Sciences, associate professor, Republican Scientific and Practical Centre of Otorhinolaryngology;
Karnialiuk V.A. – postgraduate, Republican Scientific and Practical Centre of Otorhinolaryngology;
Mirylenka А.P. – Candiate of Technical Sciences, associate professor of the Chair of Designing & Modelling, Belarusian State Agrarian Technical University.