Schwab R J
Pulmonary, Allergy and Critical Care Division, Department of Medicine, Center for Sleep and Respiratory Neurobiology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA.
Dent Clin North Am. 2001 Oct;45(4):759-96.
Upper airway imaging techniques have significantly advanced the understanding of the pathogenesis of obstructive sleep apnea and the biomechanical mechanisms by which therapeutic interventions for this disorder exert their effects. Both static and dynamic imaging studies have been used to examine the structure and function of the upper airway during wakefulness and sleep. These studies have highlighted the importance of the lateral pharyngeal walls in addition to the tongue and soft palate in modulating changes in upper airway caliber. Upper airway imaging has also been used to understand the changes in upper airway anatomy associated with weight loss, mandibular repositioning devices, and upper airway surgery. At present, upper airway imaging should be considered in patients undergoing upper airway surgery and possibly in patients being evaluated for oral appliances. MR imaging and nasopharyngoscopy are the imaging modalities of choice in patients undergoing a UPPP. Cephalometrics should be considered in patients being treated with mandibular repositioning devices. Upper airway imaging has provided an important framework to examine the pathogenesis of airway closure, and these investigations may, in time, lead to more effective treatment options for patients with sleep apnea.
上气道成像技术极大地推动了我们对阻塞性睡眠呼吸暂停发病机制以及该疾病治疗干预措施发挥作用的生物力学机制的理解。静态和动态成像研究均已用于检查清醒和睡眠状态下上气道的结构和功能。这些研究突出了除舌头和软腭之外，咽侧壁在调节上气道管径变化方面的重要性。上气道成像还被用于了解与体重减轻、下颌复位装置及上气道手术相关的上气道解剖结构变化。目前，对于接受上气道手术的患者以及可能接受口腔矫治器评估的患者，均应考虑进行上气道成像检查。磁共振成像（MR成像）和鼻咽喉镜检查是接受悬雍垂腭咽成形术（UPPP）患者的首选成像方式。对于接受下颌复位装置治疗的患者，应考虑进行头影测量。上气道成像为研究气道闭合的发病机制提供了一个重要框架，并且这些研究或许最终能为睡眠呼吸暂停患者带来更有效的治疗选择。
