講師資料
Talks：
When OSA Surgery Fails: Why and What’s Next?
OSA 手術失敗了嗎？探究原因與下一步治療策略
Name：
蔡明劭（Ming-Shao Tsai）
Position：
Professor教授
Affiliation：
嘉義長庚醫院 耳鼻喉部
Email：
Photo：
Research Interests：
Obstructive Sleep Apnea, Otorhinolaryngology
Selected Publications：
1. Ming‐Shao Tsai (1st author), Hsueh‐Yu Li, Chung‐Guei Huang, Robert YL Wang, Li‐Pang Chuang, Ning‐Hung Chen, Chi‐Hung Liu, Yao‐Hsu Yang, Chia‐Yen Liu, Cheng‐Ming Hsu, Wen‐Nuan Cheng, Li‐Ang Lee. Risk of Alzheimer's Disease in Obstructive Sleep Apnea Patients With or Without Treatment: Real-world Evidence. Laryngoscope. 2020 Feb 11. doi: 10.1002/lary.28558. Online ahead of print. (IF=2.471; R/C=7/42, 16.7%, Q1; Otorhinolaryngology)
2. Hsueh-Yu Li, Ming-Shao Tsai (Co-1st author), Chung-Guei Huang, Robert YL Wang, Li-Pang Chuang, Ning-Hung Chen, Chi-Hung Liu, Cheng-Ming Hsu, Wen-Nuan Cheng, Li-Ang Lee. Alterations in Alzheimer’s Disease-Associated Gene Expression in Severe Obstructive Sleep Apnea Patients. Journal of Clinical Medicine. 2019, 8(9):1361 (IF=5.688; R/C=15/160, 9.38%, Q1; Medicine, General & Internal)
3. Ming-Shao Tsai(1st author), Hung-Chin Chen, Stanley Yung-Chuan Liu, Li-Ang Lee, Cheng-Yu Lin , Geng-He Chang, Yao-Te Tsai, Yi-Chan Lee, Cheng-Ming Hsu, Hsueh-Yu Li. Holistic care for obstructive sleep apnea (OSA) with an emphasis on restoring nasal breathing: A review and perspective. Journal of the Chinese Medical Association. 2022 Jun 1;85(6):672-678. (IF=3.0 ; R/C=75/167, 44.9%, Q2; Medicine, General & Internal)
4. Ming-Shao Tsai(1st author), Hung-Chin Chen#, Hsueh-Yu Li, Yao-Te Tsai, Yao-Hsu Yang, Chia-Yen Liu, Yi-Chan Lee, Cheng-Ming Hsu, Li-Ang Lee. Sleep Apnea and Risk of Influenza-Associated Severe Acute Respiratory Infection: Real-World Evidence. Nature and Science of Sleep. 2022 May 10;14:901-909. (IF=3.4 ; R/C=90/212, 42.5%, Q2;Clinical Neurology)
5. Ming-Shao Tsai (1st author), Wen-Cheng Chen, Chang-Hsien Lu, Miao-Fen Chen*. The prognosis of head and neck squamous cell carcinoma related to immunosuppressive tumor microenvironment regulated by IL-6 signaling. Oral Oncology. 2019 Apr; 91:47-55. (IF=4.794; R/C=1/90, 1.1%, Q1; Dentistry, Oral Surgery & Medicine)
6. Ming-Shao Tsai (1st author), Li-Ang Lee, Yao-Te Tsai, Yao-Hsu Yang, Chia-Yen Liu, Meng-Hung Lin, Cheng-Ming Hsu MD, Chin-Kuo Chen, Hsueh-Yu Li MD*. Sleep Apnea and Risk of Vertigo: A Nationwide Population-Based Cohort Study. Laryngoscope. 2018 Mar;128:763-68. (IF=2.471; R/C=7/42, 16.7%, Q1; Otorhinolaryngology)
Abstract：
阻塞型睡眠呼吸中止症（Obstructive Sleep Apnea, OSA）的手術治療已逐漸由傳統單一術式，走向以阻塞型態與患者表型為核心的精準治療。然而，即使經過適當手術，部分患者仍可能出現治療反應不佳、殘餘性 OSA，甚至在長期追蹤後再次惡化。當 OSA 手術「失敗」時，真正需要回答的問題不只是「手術是否有效」，而是：我們是否選對病人、找對阻塞位置，並選擇了正確的治療策略？
本演講將從臨床實務角度重新解析 OSA 手術治療成效不佳的原因，包括術前患者選擇、解剖與非解剖表型、睡眠內視鏡（DISE）評估、多層次上呼吸道阻塞、手術範圍與技術，以及肥胖、體重變化與共病等因素。同時探討如何重新評估術後殘餘 OSA，辨識仍可介入的阻塞位置與可修正因素。
面對手術後仍存在的 OSA，治療並非走到終點，而是進入下一階段的精準決策。透過重新評估與表型導向策略，可進一步整合 CPAP、體重管理與 GLP-1 類藥物、口腔矯治器、進一步的多層次睡眠手術、經口機器人手術（TORS）及其他新興治療，為患者規劃個人化的後續治療路徑。
OSA 手術的成功，不應只由單一次手術或單一 AHI 數值定義。真正的目標，是了解「為什麼沒有達到預期」，並據此找到下一個最適合患者的治療選擇。
2026年會：