Golding-Wood D G, Brockbank M J, Swanston A R, Croft C B
Department of Otolaryngology, Royal Throat, Nose & Ear Hospital, London.
J R Soc Med. 1990 Jun;83(6):363-7. doi: 10.1177/014107689008300609.
Snorers represent a heterogenous group that require adequate assessment before recommending surgical treatment. There are unfortunately no specific features either in the history or physical examination that might predict those chronic snorers with obstructive sleep apnoea. We have used trained observation together with pulse oximetry ('sleep screening') and fibreoptic nasendoscopy with Muller manoeuvre in our unit to assess snorers. This combination is a reliable means of distinguishing apnoeic patients from simple snorers and determining the level of the obstructing segment. We report our experience in using these methods in the management of 71 chronic snorers. We stress the value of conservative management, and emphasize that obesity, habitual alcohol ingestion and nasal obstruction should be corrected before embarking on pharyngeal surgery.
打鼾者是一个异质性群体,在推荐手术治疗前需要进行充分评估。遗憾的是,病史或体格检查中没有任何特定特征可以预测哪些慢性打鼾者患有阻塞性睡眠呼吸暂停。在我们科室,我们采用了训练有素的观察、脉搏血氧饱和度测定(“睡眠筛查”)以及纤维鼻咽喉镜检查并配合米勒动作来评估打鼾者。这种组合是区分呼吸暂停患者和单纯打鼾者以及确定阻塞节段水平的可靠方法。我们报告了我们使用这些方法管理71例慢性打鼾者的经验。我们强调保守治疗的价值,并强调在进行咽部手术前应纠正肥胖、习惯性饮酒和鼻阻塞。