Levring Jäghagen E, Franklin K A, Isberg A
Department of Odontology/Oral and Maxillofacial Radiology, Ume University, Ume, Sweden.
Dentomaxillofac Radiol. 2003 Sep;32(5):311-6. doi: 10.1259/dmfr/29209140.
Snoring is associated with subclinical pharyngeal swallowing dysfunction, probably owing to vibration trauma to the pharyngeal tissues caused by snoring. Negative intrathoracic pressure during apnoea causes stretching of the velum and pharynx. The aim of this study was to investigate whether patients with severe sleep apnoea have an increased frequency of videoradiographically diagnosed subclinical pharyngeal swallowing dysfunction compared with snoring patients with or without mild sleep apnoea as well as with non-snoring controls.
Eighty consecutive patients referred for sleep apnoea recordings because of snoring were examined. Fourteen of these patients were excluded because they suffered from dysphagia. Fifteen non-snoring, non-dysphagic volunteers served as controls. Videoradiography was performed to examine the oral and pharyngeal swallowing function in patients and controls. Overnight sleep apnoea recordings were used to evaluate the apnoea-hypopnoea index (AHI).
Pharyngeal swallowing dysfunction was observed in 34/66 (52%) of the snoring patients and in 1/15 (7%) of the non-snoring controls. Pharyngeal swallowing dysfunction was observed in 50% of patients with an AHI of >or=30, in 61% of patients with an AHI of 5-29 and in 43% of patients with an AHI of <5. There was no significant difference in the frequency of pharyngeal swallowing dysfunction between snoring patients with different AHIs.
Snoring patients run an increased risk of developing subclinical pharyngeal swallowing dysfunction independent of concomitant sleep apnoea.
打鼾与亚临床咽部吞咽功能障碍有关,可能是由于打鼾引起的咽部组织振动损伤所致。呼吸暂停期间的胸内负压会导致软腭和咽部伸展。本研究的目的是调查与有或无轻度睡眠呼吸暂停的打鼾患者以及非打鼾对照相比,重度睡眠呼吸暂停患者经视频放射成像诊断的亚临床咽部吞咽功能障碍的发生率是否更高。
连续检查了80例因打鼾而被转诊进行睡眠呼吸暂停记录的患者。其中14例患者因吞咽困难被排除。15名非打鼾、无吞咽困难的志愿者作为对照。对患者和对照进行视频放射成像检查口腔和咽部吞咽功能。使用夜间睡眠呼吸暂停记录来评估呼吸暂停低通气指数(AHI)。
66例打鼾患者中有34例(52%)出现咽部吞咽功能障碍,15名非打鼾对照中有1例(7%)出现咽部吞咽功能障碍。AHI≥30的患者中有50%出现咽部吞咽功能障碍,AHI为5 - 29的患者中有61%出现咽部吞咽功能障碍,AHI<5的患者中有43%出现咽部吞咽功能障碍。不同AHI的打鼾患者之间咽部吞咽功能障碍的发生率无显著差异。
打鼾患者发生亚临床咽部吞咽功能障碍的风险增加,与是否伴有睡眠呼吸暂停无关。