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阻塞性睡眠呼吸暂停:耳鼻喉科医生的作用。

Obstructive Sleep Apnea: Role of an Otorhinolaryngologist.

作者信息

Shah Jinesh Atulkumar, George Ajay, Chauhan Nirali, Francis Stani

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, Smt. B. K. Shah Medical Institute and Research Centre, Piparia, Waghodia, Vadodara, Gujarat 391760 India.

Department of Respiratory Medicine, Smt. B. K. Shah Medical Institute and Research Centre, Piparia, Waghodia, Vadodara, Gujarat 391760 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2016 Mar;68(1):71-4. doi: 10.1007/s12070-015-0922-8. Epub 2015 Oct 20.

Abstract

Obstructive sleep apnea is a disorder resulting from collapse of the upper airway during sleep. Its etiology is multifactorial, resulting from the interdependence of structurally vulnerable upper airway anatomy interacting with physiologic mechanism of ventilator instability during sleep. The ENT causes for OSA are relatively simple conditions that can be treated by safe and simple medical and/or surgical procedures. To assess the prevalence of ENT disorders in patients presenting to the sleep clinic. Patients presented to sleep clinic were submitted to an assessment protocol including clinical history, otorhinolaryngology examination and a polysomnography. Total 69 patients were included and distributed into two groups according to AHI: patients with sleep disordered breathing only (simple snorer and/or AHI ≤ 5) and patients with obstructive sleep apnea syndrome (AHI > 5). There was significant statistical difference for deviated nasal septum (p = 0.0004) and inferior turbinate hypertrophy (p = 0.03) in both groups. Most patients were in the class III and IV of Mallampati classification. Odds of having OSA increases more than 1.5 folds as the level of Mallampati classification increases by one class. ENT disorders were more common in the patients with OSA than in simple snorers and have impact on pathophysiology of OSA and its treatment modality. Hence, ENT examination in all patients with sleep disordered breathing will be helpful.

摘要

阻塞性睡眠呼吸暂停是一种睡眠期间上呼吸道塌陷所致的疾病。其病因是多因素的,源于结构脆弱的上呼吸道解剖结构与睡眠期间呼吸机不稳定的生理机制之间的相互依存关系。阻塞性睡眠呼吸暂停的耳鼻喉科病因相对简单,可通过安全、简单的医学和/或外科手术进行治疗。为评估睡眠诊所患者中耳鼻喉科疾病的患病率。就诊于睡眠诊所的患者接受了包括临床病史、耳鼻喉科检查和多导睡眠图在内的评估方案。共纳入69例患者,并根据呼吸暂停低通气指数(AHI)分为两组:仅患有睡眠呼吸障碍的患者(单纯打鼾者和/或AHI≤5)和阻塞性睡眠呼吸暂停综合征患者(AHI>5)。两组患者的鼻中隔偏曲(p = 0.0004)和下鼻甲肥大(p = 0.03)存在显著统计学差异。大多数患者属于Mallampati分类的III级和IV级。随着Mallampati分类等级每增加一级,患阻塞性睡眠呼吸暂停的几率增加超过1.5倍。耳鼻喉科疾病在阻塞性睡眠呼吸暂停患者中比单纯打鼾者更常见,并且对阻塞性睡眠呼吸暂停的病理生理学及其治疗方式有影响。因此,对所有睡眠呼吸障碍患者进行耳鼻喉科检查将有所帮助。

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