Barceló Xavier, Mirapeix Rosa M, Bugés Jordi, Cobos Albert, Domingo Christian
Servei de Pneumologia, Corporació Parc Taulí, Parc Taulí s/n, Sabadell, Barcelona, Spain.
Arch Otolaryngol Head Neck Surg. 2011 Oct;137(10):990-6. doi: 10.1001/archoto.2011.176.
To evaluate the usefulness of the examination of the upper airway, paying special attention to the Friedman tongue position (FTP), to confirm obstructive sleep apnea syndrome (OSAS) and its severity.
Prospective, single-center, cross-sectional study.
Sleep disorders unit of a community hospital.
A total of 301 consecutive patients admitted to the sleep disorders unit due to suspicion of OSAS. Assessments included body mass index calculated as weight in kilograms divided by height in meters squared (BMI); neck perimeter measurement; oropharyngeal examination; fiberendoscopy; rhinomanometry; and a sleep study.
Apnea-hypopnoea index (AHI), FTP, the uvula size, and certain complementary examinations (sex, age, BMI, cervical perimeter, nasal flow) whose importance has not been clearly established, and to explore their potential value as predictors of the AHI.
Findings included the following: the mean (SD) age of the patients was 51 (12) years; 71.1% were male; the mean (SD) BMI was 29.8 (4.6); and the mean (SD) cervical perimeter, 40.5 (3.7) cm. In 94.0% of the patients the AHI value was at least 5.0/hour. Patients with FTP scores of 2 and 3 accounted for 74.1% of the whole cohort: 14.3% had an FTP score of 1, and only 11.6% had a score of 4. Of the 6.0% of cases with a normal AHI, 16 patients were classified as having FTP scores of 1, and 2 as having a score of 2. Tonsil size score (P = .005), uvula score (P = .003), BMI (P < .001), cervical perimeter (P < .001), nasal flow at 150 Pa (P = .02), and age (P = .007) were related to OSAS severity. Curiously, AHI in patients who had undergone tonsillectomy was higher than in the TS1 group (tonsils inside the tonsillar fossa) and quite similar to the TS 2 group (tonsils that extend beyond the tonsillar pillars). In the multiple regression model, only the FTP score showed a relevant relationship to OSAS severity.
First, since the FTP score is almost the only parameter related to OSAS severity, a simple oropharyngeal examination can provide key information on this issue. Second, tonsillectomy does not seem to protect against development of OSAS.
评估上气道检查的效用，尤其关注弗里德曼舌位（FTP），以确诊阻塞性睡眠呼吸暂停综合征（OSAS）及其严重程度。
前瞻性、单中心横断面研究。
一家社区医院的睡眠障碍科。
共有301例因疑似OSAS入住睡眠障碍科的连续患者。评估内容包括体重指数（以千克为单位的体重除以身高米数的平方计算得出，即BMI）；颈围测量；口咽检查；纤维内镜检查；鼻阻力测量；以及睡眠研究。
呼吸暂停低通气指数（AHI）、FTP、悬雍垂大小，以及某些重要性尚未明确的补充检查（性别、年龄、BMI、颈围、鼻气流），并探讨它们作为AHI预测指标的潜在价值。
研究结果如下：患者的平均（标准差）年龄为51（12）岁；71.1%为男性；平均（标准差）BMI为29.8（4.6）；平均（标准差）颈围为40.5（3.7）厘米。94.0%的患者AHI值至少为5.0次/小时。FTP评分为2分和3分的患者占整个队列的74.1%：14.3%的患者FTP评分为1分，只有11.6%的患者评分为4分。在AHI正常的6.0%的病例中，16例患者的FTP评分为1分，2例评分为2分。扁桃体大小评分（P = .005）、悬雍垂评分（P = .003）、BMI（P < .001）、颈围（P < .001）、150 Pa时的鼻气流（P = .02）和年龄（P = .007）与OSAS严重程度相关。奇怪的是，接受扁桃体切除术后患者的AHI高于TS1组（扁桃体位于扁桃体窝内），与TS2组（扁桃体超出扁桃体柱）相当。在多元回归模型中，只有FTP评分与OSAS严重程度显示出相关性。
第一，由于FTP评分几乎是与OSAS严重程度相关的唯一参数，简单的口咽检查可以提供关于这个问题的关键信息。第二，扁桃体切除术似乎并不能预防OSAS的发生。
