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评价一种用于阻塞性睡眠呼吸相关障碍患者的鼻咽支架。

Evaluation of a nasopharyngeal stent in patients with obstructive sleep-related breathing disorders.

机构信息

Department of Otolaryngology - Head and Neck Surgery, Kantonsspital Baselland, Liestal, Baselland, Switzerland.

出版信息

J Int Med Res. 2022 Jan;50(1):3000605211073302. doi: 10.1177/03000605211073302.

Abstract

OBJECTIVE

This study was performed to evaluate the therapeutic effect and diagnostic value of a novel nasopharyngeal stent (Naśtent; Corinium Medical Equipment Ltd., Cirencester, UK). The Naśtent is designed to stent palatal collapse in patients with sleep-related breathing disorders.

METHODS

The study was conducted from 2018 to 2019. Patients who did not qualify for continuous positive airway pressure therapy underwent split-night examination with an inserted Naśtent for the first half of the night. The next morning, drug-induced sleep endoscopy (DISE) was performed.

RESULTS

Of the 122 enrolled patients, 21 were excluded because of Naśtent intolerance (n = 14) or technically invalid examinations (n = 7). Among the remaining 101 patients, in correlation with DISE, the apnea-hypopnea index was significantly reduced in patients with palatal obstructions, mainly in those with anteroposterior collapse patterns. The Naśtent did not influence retrolingual or multilevel obstructions. Using a 40% reduction of the apnea-hypopnea index by the Naśtent as a cut-off value, 85.7% of soft palate obstructions were detected compared with DISE.

CONCLUSIONS

The Naśtent is a viable tool to reduce palatal obstructions, although it is not readily tolerated. It may also be helpful for diagnosis of sleep-related breathing disorders when DISE is unavailable.

摘要

目的

本研究旨在评估新型鼻咽支架(Naśtent;Corinium Medical Equipment Ltd.,英国 Cirencester)的治疗效果和诊断价值。Naśtent 设计用于支撑睡眠呼吸障碍患者的腭塌陷。

方法

该研究于 2018 年至 2019 年进行。不符合持续气道正压治疗条件的患者在夜间前半段接受插入 Naśtent 的分夜检查。第二天早上,进行药物诱导睡眠内窥镜检查(DISE)。

结果

在 122 名入组患者中,有 21 名因 Naśtent 不耐受(n=14)或检查技术无效(n=7)而被排除。在剩余的 101 名患者中,与 DISE 相关,腭阻塞患者的呼吸暂停-低通气指数显著降低,主要是前后塌陷模式的患者。Naśtent 不影响舌后或多水平阻塞。使用 Naśtent 将呼吸暂停-低通气指数降低 40%作为截断值,与 DISE 相比,85.7%的软腭阻塞被检测到。

结论

虽然 Naśtent 不易耐受,但它是一种降低腭阻塞的有效工具。当无法进行 DISE 时,它也可能有助于诊断睡眠呼吸障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d3b/8796092/863f58603c90/10.1177_03000605211073302-fig1.jpg

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