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药物诱导睡眠鼻内镜检查对打鼾声源的研究

Investigation of the Source of Snoring Sound by Drug-Induced Sleep Nasendoscopy.

作者信息

Xu Hui-Jie, Jia Rui-Fang, Yu Hui, Gao Zhan, Huang Wei-Ning, Peng Hao, Yang Yi, Zhang Lei

机构信息

Department of Otolaryngology, Beijing Hospital, Beijing, PR China.

出版信息

ORL J Otorhinolaryngol Relat Spec. 2015;77(6):359-65. doi: 10.1159/000439597. Epub 2015 Oct 14.

Abstract

OBJECTIVE

To investigate the source of snoring sound in patients with simple snoring (SS) and different degrees of obstructive sleep apnea syndrome (OSAS) in order to provide a basis for the surgical treatment of snoring.

METHODS

Fifty-two patients with either SS or OSAS (with an apnea-hypopnea index ≤40) underwent drug-induced sleep nasendoscopy (DISN). Vibration sites in the pharyngeal cavity were observed.

RESULTS

Vibration of the soft palate, pharyngeal lateral wall, epiglottis, and tongue base appeared in 100, 53.8, 42.3, and 26.9% of the patients, respectively. The source of snoring sound was divided into two types: palatal fluttering only (type I) and multisite vibration (type II). The latter was divided into 3 subtypes: palatal fluttering with epiglottis vibration (type IIa), palatal fluttering with lateral wall vibration (type IIb), and palatal fluttering with vibration of the lateral wall, epiglottis, and tongue base together (type IIc). The distribution of type I snoring was the highest in SS patients. Type IIb was more common in patients with medium and severe OSAS. Type IIc was most common in patients with severe OSAS.

CONCLUSION

The source of snoring sound is diverse, with SS and OSAS patients showing different features. DISN is a very effective method of identifying the snoring source.

摘要

目的

探讨单纯鼾症(SS)及不同程度阻塞性睡眠呼吸暂停低通气综合征(OSAS)患者鼾声来源,为鼾症的外科治疗提供依据。

方法

52例SS或OSAS(呼吸暂停低通气指数≤40)患者接受药物诱导睡眠鼻内镜检查(DISN),观察咽腔振动部位。

结果

软腭、咽侧壁、会厌及舌根振动分别出现在100%、53.8%、42.3%及26.9%的患者中。鼾声来源分为两种类型:仅软腭扑动(I型)和多部位振动(II型)。后者又分为3个亚型:软腭扑动与会厌振动(IIa型)、软腭扑动与侧壁振动(IIb型)、软腭扑动与侧壁、会厌及舌根同时振动(IIc型)。I型鼾声在SS患者中分布最高。IIb型在中重度OSAS患者中更常见。IIc型在重度OSAS患者中最常见。

结论

鼾声来源多样,SS和OSAS患者表现出不同特征。DISN是识别鼾声来源的一种非常有效的方法。

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