Li Shuhua, Gao Li, Zou Mingyu, Qu Sheng, Shi Hongjin, Dong Weidong, Zou Liangui
Department of Otolaryngology, Shenyang General Hospital of PLA, Shenyang 110015, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2008 Aug;22(15):673-7.
To observe the effects of pressure level in veil on upper airway in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and normal adults.
We scanned the upper airway from roof of nasopharynx to glottis with SIMENS 16 layer spiral CT scanner. The area and the dimensions of palate, uvula, and the region after lingua and epiglottis were measured by application of image work station. Forty-six patients with OSAHS and 35 normal adults were scanned by CT at 0 kPa water column and 0.784 kPa water column pressures in face mask, respectively.
The area and inner diameter of OSAHS patients upper airways were less than those of normal adults at the same pressure in face mask. The area and inner diameter of upper airway at the pressure of 0.784 kPa water column were more than those at 0 kPa water column in both OSAHS patients and normal adults, and the increased extent of normal adults were more than those of OSAHS patients. We measured the minimum increased normal Cross sectional area of palate, uvula, and the region after lingua and epiglottis when the pressure in the mask increased from 0 kPa to 0.784 kPa, and we made it as the standard. The 46 OSAHS patients were sorted into 17 cases (group 1) with normal dilation and 29 cases (group 2) with less dilation in such standard. There was not significant difference between the two groups at 0 kPa pressures in area and inner diameter, but the area and inner diameter of group 1 were more than those of group 2 at 0.784 kPa pressure.
The increased pressure in face mask would lead to upper airway dilation both in OSAHS patients and normal adults, and the dilated extents of normal adults were significant more than those of OSAHS patients. The less dilation of OSAHS may be duo to anatomic constriction and some pharynx wall pathological changes.
观察面罩压力水平对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者及正常成年人上气道的影响。
采用西门子16层螺旋CT扫描仪从鼻咽顶至声门对患者上气道进行扫描。应用图像工作站测量腭、悬雍垂以及舌后会厌区的面积和尺寸。46例OSAHS患者和35例正常成年人分别在面罩压力为0 kPa水柱和0.784 kPa水柱时进行CT扫描。
在相同面罩压力下，OSAHS患者上气道的面积和内径小于正常成年人。在0.784 kPa水柱压力时，OSAHS患者和正常成年人上气道的面积和内径均大于0 kPa水柱时，且正常成年人的增加幅度大于OSAHS患者。测量面罩压力从0 kPa增加到0.784 kPa时，腭、悬雍垂以及舌后会厌区正常增加的最小横截面积，并以此作为标准。将46例OSAHS患者按此标准分为扩张正常组17例（第1组）和扩张较差组29例（第2组）。两组在0 kPa压力时面积和内径无显著差异，但在0.784 kPa压力时第1组的面积和内径大于第2组。
面罩压力增加可导致OSAHS患者和正常成年人上气道扩张，且正常成年人的扩张程度明显大于OSAHS患者。OSAHS患者扩张较差可能是由于解剖结构狭窄和咽部壁的一些病理改变所致。
