Ying Binbin, Huang Qiuli, Su Yingsheng, Fu Bonian, Ye Xianwang, Huang Yiqin, Li Zheguang
Stomatology Department, Ningbo First Hospital, Ningbo, China.
J Craniofac Surg. 2012 May;23(3):675-7. doi: 10.1097/SCS.0b013e31824dbad3.
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is one of the most common sleep disorders that have significant associated health costs. It is caused by recurrent occlusion of the upper airway during sleep. Recently, many researchers have provided evidence that patients with OSAHS tend to have a large tongue, a comparatively prolonged soft palate, and a narrow upper airway.There are many therapeutic methods for OSAHS, although determining the obstructive points is very important. Several methods to study the morphology of the upper airway in patients with OSAHS are available: acoustic reflection, fluoroscopy, endoscopic observation, and computed tomography (CT). After our hospital took the lead in the introduction the first 320-detector CT in East China, our team studied the morphology of the upper airway in patients with OSAHS using this 320-detector CT.From July 2010 to July 2011, the upper airway of 66 patients with OSAHS and 22 control subjects were scanned using a 320-detector CT scanner at the time of deep inspiration, deep expiration, normal respiration, and Müller maneuver. Cross-sectional areas of the upper airway at the nasopharyngeal, velopharyngeal, and tongue-pharyngeal levels were measured and compared. Mean velopharyngeal cross-sectional areas in OSAHS were less than those in the control group at the time of deep inspiration, deep expiration, normal respiration, and Müller maneuver (P < 0.05). Mean tongue-pharyngeal cross-sectional areas in OSAHS were less than those in the control group at the time of deep inspiration and Müller maneuver (P < 0.05).The results showed that velopharyngeal and tongue-pharyngeal areas could be the main obstructive regions for OSAHS and that the 320-detector CT scanner would be of great utility in identifying the location of the upper airway obstruction in patients with OSAHS, in exploring the pathogenesis of OSAHS, and in designing the appropriate treatment plan and surgical positioning.
阻塞性睡眠呼吸暂停低通气综合征（OSAHS）是最常见的睡眠障碍之一，会产生高昂的相关健康成本。它是由睡眠期间上呼吸道反复阻塞引起的。最近，许多研究人员已证实，OSAHS患者往往舌头较大、软腭相对较长且上呼吸道狭窄。OSAHS有多种治疗方法，不过确定阻塞点非常重要。有几种研究OSAHS患者上呼吸道形态的方法：声反射、荧光镜检查、内镜观察和计算机断层扫描（CT）。我院在华东地区率先引进首台320排CT后，我们团队使用这台320排CT研究了OSAHS患者的上呼吸道形态。2010年7月至2011年7月，对66例OSAHS患者和22例对照者的上呼吸道在深吸气、深呼气、正常呼吸和米勒动作时进行了320排CT扫描。测量并比较了鼻咽、腭咽和舌咽水平上呼吸道的横截面积。在深吸气、深呼气、正常呼吸和米勒动作时，OSAHS患者的平均腭咽横截面积均小于对照组（P<0.05）。在深吸气和米勒动作时，OSAHS患者的平均舌咽横截面积小于对照组（P<0.05）。结果表明，腭咽和舌咽区域可能是OSAHS的主要阻塞部位，320排CT扫描仪在识别OSAHS患者上呼吸道阻塞位置、探索OSAHS发病机制以及设计合适的治疗方案和手术定位方面具有很大实用价值。
