阻塞性睡眠呼吸暂停患者的咽鼓管功能障碍及持续气道正压通气治疗的改善作用。
Eustachian tube dysfunction in sleep apnea patients and improvements afforded by continuous positive airway pressure therapy.
机构信息
Aksaray University, Aksaray Education and Research Hospital, Department of ENT, Aksaray, Turkey.
Giresun University, A. Ilhan Ozdemir Education and Research Hospital, Department of ENT, Giresun, Turkey.
出版信息
Braz J Otorhinolaryngol. 2021 May-Jun;87(3):333-337. doi: 10.1016/j.bjorl.2020.02.003. Epub 2020 Mar 12.
INTRODUCTION
Upper airway resistance may accompany eustachian dysfunction and alter middle ear pressure in patients with obstructive sleep apnea syndrome.
OBJECTIVE
To investigate effects of obstructive sleep apnea syndrome and continuous positive airway pressure treatment on eustachian tube functions.
METHODS
Forty-two mild obstructive sleep apnea syndrome patients, 45 moderate obstructive sleep apnea syndrome patients, 47 severe obstructive sleep apnea syndrome patients with continuous positive airway pressure therapy, 32 severe obstructive sleep apnea syndrome patients without continuous positive airway pressure therapy, and 88 individuals without sleep apnea (controls) were included. Tympanometric parameters of groups were compared.
RESULTS
Right middle ear pressures in mild and moderate obstructive sleep apnea syndrome groups did not differ significantly from that of control group (p = 0.93 and p = 0.55), as was also true of the left middle ear pressures (p = 0.94 and p = 0.86). Right middle ear pressure was significantly higher in severe obstructive sleep apnea syndrome groups than in the control group, as was the left middle ear pressure (p < 0.001). Middle ear pressure (negative) was significantly lower in severe obstructive sleep apnea syndrome patients with continuous positive airway pressure therapy compared to those without (p < 0.001). Right ear type B and C tympanogram frequencies were significantly higher in patients with severe obstructive sleep apnea syndrome without continuous positive airway pressure therapy (12.4%) than in the controls (0%) (p = 0.02). Left ear type B or C tympanogram frequencies were significantly higher in patients with severe obstructive sleep apnea syndrome without continuous positive airway pressure therapy (21.9%) than in the controls (0%) (p = 0.002).
CONCLUSION
Mild and moderate obstructive sleep apnea syndrome did not affect middle ear pressure but severe obstructive sleep apnea syndrome may increase the (negative) middle ear pressure. In severe obstructive sleep apnea syndrome patients, long-term continuous positive airway pressure therapy may normalize middle ear pressure.
介绍
上气道阻力可能伴随着咽鼓管功能障碍，并改变阻塞性睡眠呼吸暂停综合征患者的中耳压力。
目的
研究阻塞性睡眠呼吸暂停综合征及持续气道正压通气治疗对咽鼓管功能的影响。
方法
纳入 42 例轻度阻塞性睡眠呼吸暂停综合征患者、45 例中度阻塞性睡眠呼吸暂停综合征患者、47 例重度阻塞性睡眠呼吸暂停综合征患者（持续气道正压通气治疗）、32 例重度阻塞性睡眠呼吸暂停综合征患者（未行持续气道正压通气治疗）和 88 例无睡眠呼吸暂停者（对照组）。比较各组的鼓室压参数。
结果
轻度和中度阻塞性睡眠呼吸暂停综合征组的右侧中耳压力与对照组相比无显著差异（p=0.93 和 p=0.55），左侧中耳压力也如此（p=0.94 和 p=0.86）。重度阻塞性睡眠呼吸暂停综合征组的右侧中耳压力明显高于对照组，左侧中耳压力也如此（p<0.001）。与未行持续气道正压通气治疗的患者相比，行持续气道正压通气治疗的重度阻塞性睡眠呼吸暂停综合征患者的中耳压力（负值）显著降低（p<0.001）。未行持续气道正压通气治疗的重度阻塞性睡眠呼吸暂停综合征患者中，右侧鼓室图 B 型和 C 型的频率明显高于对照组（12.4%比 0%）（p=0.02）。左侧鼓室图 B 型或 C 型的频率也明显高于对照组（21.9%比 0%）（p=0.002）。
结论
轻度和中度阻塞性睡眠呼吸暂停综合征不会影响中耳压力，但重度阻塞性睡眠呼吸暂停综合征可能会增加（负值）中耳压力。在重度阻塞性睡眠呼吸暂停综合征患者中，长期持续气道正压通气治疗可能使中耳压力正常化。
Zotero 插件