Arens R, McDonough J M, Costarino A T, Mahboubi S, Tayag-Kier C E, Maislin G, Schwab R J, Pack A I
Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104-4399, USA.
Am J Respir Crit Care Med. 2001 Aug 15;164(4):698-703. doi: 10.1164/ajrccm.164.4.2101127.
The anatomical relationships between lymphoid, bony, and other tissues affecting the shape of the upper airway in children with obstructive sleep apnea syndrome (OSAS) have not been established. We therefore compared the upper airway structure in 18 young children with OSAS (age 4.8 +/- 2.1 yr; 12 males and 6 females) and an apnea index of 4.3 +/- 3.9, with 18 matched control subjects (age, 4.9 +/- 2.0 yr; 12 males and 6 females). All subjects underwent magnetic resonance imaging under sedation. Axial and sagittal T1- and T2-weighted sequences were obtained. Images were analyzed with image-processing software to obtain linear, area, and volumetric measurements of the upper airway and the tissues comprising the airway. The volume of the upper airway was smaller in subjects with OSAS in comparison with control subjects (1.5 +/- 0.8 versus 2.5 +/- 1.2 cm(3); p < 0.005) and the adenoid and tonsils were larger (9.9 +/- 3.9 and 9.1 +/- 2.9 cm(3) versus 6.4 +/- 2.3 and 5.8 +/- 2.2 cm(3); p < 0.005 and p < 0.0005, respectively). Volumes of the mandible and tongue were similar in both groups; however, the soft palate was larger in subjects with OSAS (3.5 +/- 1.1 versus 2.7 +/- 1.2 cm(3); p < 0.05). We conclude that in children with moderate OSAS, the upper airway is restricted both by the adenoid and tonsils; however, the soft palate is also larger in this group, adding further restriction.
阻塞性睡眠呼吸暂停综合征（OSAS）患儿中，影响上气道形态的淋巴组织、骨骼组织及其他组织之间的解剖学关系尚未明确。因此，我们比较了18名患有OSAS的幼儿（年龄4.8±2.1岁；男12名，女6名）和18名匹配的对照受试者（年龄4.9±2.0岁；男12名，女6名）的上气道结构，这些OSAS患儿的呼吸暂停指数为4.3±3.9。所有受试者均在镇静状态下接受磁共振成像检查。获取了轴向和矢状面的T1加权及T2加权序列图像。使用图像处理软件对图像进行分析，以获取上气道及构成气道的组织的线性、面积和容积测量值。与对照受试者相比，OSAS受试者的上气道容积较小（1.5±0.8对2.5±1.2 cm³；p<0.005），腺样体和扁桃体较大（9.9±3.9和9.1±2.9 cm³对6.4±2.3和5.8±2.2 cm³；p分别<0.005和p<0.0005）。两组的下颌骨和舌的容积相似；然而，OSAS受试者的软腭较大（3.5±1.1对2.7±1.2 cm³；p<0.05）。我们得出结论，在中度OSAS患儿中，上气道受到腺样体和扁桃体的双重限制；然而，该组患儿的软腭也较大，进一步加重了气道狭窄。
