Rasche H, Köster R, Schultz-Coulon H J
Klinik für HNO-Krankheiten, Kopf- und Halschirurgie, Lukaskrankenhaus GmbH, Städtische Kliniken Neuss.
HNO. 1991 Dec;39(12):451-9.
A programme for the differential diagnosis of rhonchopathy is reported, based upon the MESAM system developed at the University of Marburg. With this biparametric long-term monitor the snoring noise and the heart beat frequency (a beat-by-beat analysis) were recorded in 94 patients with a history of snoring. Other investigations included tape recordings of the snoring noise, nasoendoscopy, pulsed cineradiography of the pharynx and the recording of the character of the snoring. This programme is much cheaper than a sleep laboratory, but it can distinguish between obstructive sleep apnoea syndrome, habitual rhonchopathy and non-snorers, mainly by means of the characteristic patterns of MESAM recordings. A sleep apnoea syndrome was diagnosed in 19 patients and habitual rhonchopathy in 38 patients, whereas 33 patients were regarded as non-snorers. Ten of our 19 patients with sleep apnoea were re-examined by a sleep laboratory and the diagnosis was proved in all of these cases. In the 38 patients with habitual rhonchopathy auditory analysis of the snoring noise classified 23 patients as velar and 10 as pharyngeal snorers; 5 patients showed a mixed type of rhonchopathy. The questionnaire accompanying the MESAM system, nasal endoscopy and cine films support the individual diagnosis by revealing typical complaints and characteristic organic findings and thus contribute to the differential diagnostic screening. However, the three groups do overlap quite markedly with respect to symptoms und organic findings. In summary, the MESAM system provides an economically viable examination programme that can be used routinely by the otorhinolaryngologist for the differential diagnosis of rhonchopathy.
本文报告了一项基于马尔堡大学研发的MESAM系统的鼾症鉴别诊断方案。使用这种双参数长期监测仪,对94例有打鼾病史的患者记录了鼾声和心跳频率(逐搏分析)。其他检查包括鼾声录音、鼻内镜检查、咽部脉冲电影造影以及打鼾特征记录。该方案比睡眠实验室检查便宜得多,但主要通过MESAM记录的特征模式,能够区分阻塞性睡眠呼吸暂停综合征、习惯性鼾症和非打鼾者。诊断出19例睡眠呼吸暂停综合征患者和38例习惯性鼾症患者,而33例患者被视为非打鼾者。我们的19例睡眠呼吸暂停患者中有10例由睡眠实验室重新检查,所有这些病例的诊断均得到证实。在38例习惯性鼾症患者中,对鼾声的听觉分析将23例患者归类为腭部打鼾者,10例为咽部打鼾者;5例患者表现为混合型鼾症。MESAM系统附带的问卷、鼻内镜检查和电影胶片通过揭示典型症状和特征性器质性发现来支持个体诊断,从而有助于鉴别诊断筛查。然而,这三组在症状和器质性发现方面有相当明显的重叠。总之,MESAM系统提供了一种经济可行的检查方案,耳鼻喉科医生可常规用于鼾症的鉴别诊断。