睡眠呼吸暂停中脸颊外观的诊断效能
Diagnostic performance of cheeks appearance in sleep apnea.
作者信息
Prikladnicki Aline, Martinez Denis, Brunetto Melissa Giacomelli, Fiori Cintia Zappe, Lenz Maria do Carmo Sfreddo, Gomes Erissandra
机构信息
a Centro de Estudos em Fonoaudiologia Clínica (CEFAC) , Porto Alegre , Brazil.
b Graduate Program in Cardiology and Cardiological Sciences, Faculdade de Medicina , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , Brazil.
出版信息
Cranio. 2018 Jul;36(4):214-221. doi: 10.1080/08869634.2017.1376426. Epub 2017 Sep 21.
OBJECTIVE
Obstructive sleep apnea (OSA) is a common, potentially life-threatening, but underdiagnosed condition. The study aimed to test the role of facial myofunctional alterations in OSA screening.
METHOD
Sixty-one individuals with sleep complaints were evaluated by the Orofacial Myofunctional Evaluation with Scores (OMES) protocol before undergoing polysomnography. The performance of each of the protocol scores in OSA screening was tested.
RESULTS
The nonparametric correlation of the apnea-hypopnea index (AHI) was significant for 18 of the 41 variables of the OMES protocol. Cheeks appearance had the best performance, increasing five times the odds for AHI ≥ 15. Its sensitivity was 66%; specificity, 72%; the area under the ROC curve, 0.69; positive and negative likelihood ratios, respectively, 2.38 and 0.47.
DISCUSSION
Cheeks appearance may be an instantly visible surrogate of tongue and pharyngeal fat deposition and of muscle function in OSA screening. Adding the item "cheeks appearance" to OSA screening tools and questionnaires may be useful for the identification of OSA risk.
目的
阻塞性睡眠呼吸暂停（OSA）是一种常见的、可能危及生命但诊断不足的病症。本研究旨在测试面部肌功能改变在OSA筛查中的作用。
方法
61名有睡眠问题的个体在进行多导睡眠图检查前，通过口面部肌功能评分评估（OMES）方案进行评估。测试了该方案各项评分在OSA筛查中的表现。
结果
OMES方案的41个变量中有18个与呼吸暂停低通气指数（AHI）的非参数相关性显著。脸颊外观表现最佳，使AHI≥15的几率增加了五倍。其敏感性为66%；特异性为72%；ROC曲线下面积为0.69；阳性和阴性似然比分别为2.38和0.47。
讨论
在OSA筛查中，脸颊外观可能是舌部和咽部脂肪沉积以及肌肉功能的一个即时可见的替代指标。在OSA筛查工具和问卷中增加“脸颊外观”这一项，可能有助于识别OSA风险。
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