Sistla Srinivas Kishore, Paramasivan Vijaya Krishnan, Agrawal Vikas
Department of ENT, Star Hospital, Block B, Road Number 10, Banjara Hills, Hyderabad 500034, Telangana, India.
Department of Snoring & Sleep Disorders, Madras ENT Research Foundation, 1, Ist Cross Street, Off II Main Road, Raja Annamalaipuram, Chennai 600028, Tamil Nadu, India.
Sleep Med Clin. 2019 Mar;14(1):21-31. doi: 10.1016/j.jsmc.2018.11.003.
Evaluation of the upper airway is key for a successful surgical management. Proper evaluation can be done only with a good understanding of the anatomy and pathophysiology of the upper airway. The authors discuss surgical anatomy from a soft tissue and bony perspective in detail along with its clinical implications. The complex interaction among pharyngeal dilator tone, arousal threshold, respiratory control instability, and changes in lung volume during sleep play an important role in obstructive sleep apnea. Because all the anatomic and physiologic characteristics discussed have genetic predisposition, gene therapy may play a pivotal role in the future.
对上气道进行评估是手术成功管理的关键。只有充分了解上气道的解剖结构和病理生理学，才能进行恰当的评估。作者从软组织和骨骼角度详细讨论了手术解剖结构及其临床意义。睡眠期间咽部扩张肌张力、觉醒阈值、呼吸控制不稳定以及肺容量变化之间的复杂相互作用在阻塞性睡眠呼吸暂停中起重要作用。由于所讨论的所有解剖和生理特征都有遗传易感性，基因治疗在未来可能发挥关键作用。
