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采用定量计算机辅助视频内镜气道分析评估悬雍垂腭咽成形术的效果

Uvulopalatopharyngoplasty outcome assessment with quantitative computer-assisted videoendoscopic airway analysis.

作者信息

Hsu Pon Poh, Tan Alvin Kah Leong, Tan Barrie Yau Boon, Gan Eng Cern, Chan Yiong Huak, Blair Robin L, Lu Peter Kuo Sun

机构信息

Division of Otolaryngology, Changi General Hospital, Singapore, Republic of Singapore.

出版信息

Acta Otolaryngol. 2007 Jan;127(1):65-70. doi: 10.1080/00016480600672659.

Abstract

CONCLUSION

Quantitative digital imaging upper airway analysis enables surgeons to assess the pre- and postoperative upper airway morphology quantitatively, objectively and accurately, and to correlate these changes in surgical parameters with improvement of obstructive sleep apnea.

OBJECTIVE

This was a prospective study using a new method of quantitative computer-assisted digital-imaging videoendoscopic upper airway analysis to quantify objectively and correlate the changes in surgical parameters with improvement of obstructive sleep apnea following uvulopalatopharyngoplasty.

PATIENTS AND METHODS

Nineteen male patients underwent uvulopalatopharyngoplasty for obstructive sleep apnea after continuous positive airway pressure trial. All had undergone pre- and postoperative digital imaging upper airway examination, Epworth scores, and polysomnographic studies. Postoperative static and dynamic changes in upper airway parameters were compared, analyzed and correlated with improvement of the apnea-hypopnea index (AHI) by statistical regression.

RESULTS

There were 65.12% and 64.37% improvements in the AHI and Epworth scales, respectively, after uvulopalatopharyngoplasty. Retropalatal areas measured were significantly correlated with improvement of the AHI. A 1 cm2 increase in retropalatal area during Mueller's maneuver in the supine position resulted in an improvement of 32.65 in the AHI; a 1 cm increase in the transverse diameter of the retropalatal area in the erect position resulted in an improvement of 31.83 in the AHI.

摘要

结论

定量数字成像上气道分析使外科医生能够客观、准确地定量评估上气道手术前后的形态,并将这些手术参数的变化与阻塞性睡眠呼吸暂停的改善情况相关联。

目的

本研究为前瞻性研究,采用一种新的计算机辅助定量数字成像视频内镜上气道分析方法,客观量化悬雍垂腭咽成形术后手术参数的变化及其与阻塞性睡眠呼吸暂停改善情况的相关性。

患者与方法

19例男性患者在持续气道正压通气试验后因阻塞性睡眠呼吸暂停接受悬雍垂腭咽成形术。所有患者均接受了手术前后的数字成像上气道检查、Epworth评分及多导睡眠图研究。通过统计回归比较、分析上气道参数的术后静态和动态变化,并将其与呼吸暂停低通气指数(AHI)的改善情况相关联。

结果

悬雍垂腭咽成形术后,AHI和Epworth量表分别改善了65.12%和64.37%。测量的软腭后区与AHI的改善显著相关。仰卧位米勒动作时软腭后区面积增加1 cm²,AHI改善32.65;直立位软腭后区横径增加1 cm,AHI改善31.83。

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