Kazemeini Elahe, Van de Perck Eli, Dieltjens Marijke, Willemen Marc, Verbraecken Johan, Op de Beeck Sara, Vanderveken Olivier M
Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Ear, Nose, Throat, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.
Front Neurol. 2022 Feb 22;13:775709. doi: 10.3389/fneur.2022.775709. eCollection 2022.
It is crucial to understand the underlying pathophysiology of obstructive sleep apnea (OSA). Upper airway collapsibility is an important pathophysiological factor that affects the upper airway in OSA. The aim of the current study was to review the existing body of knowledge on the pharyngeal collapsibility in OSA. After a thorough search through Medline, PubMed, Scopus, and Web of science, the relevant articles were found and used in this study. Critical closing pressure (Pcrit) is the gold standard measure for the degree of collapsibility of the pharyngeal airway. Various physiological factors and treatments affect upper airway collapsibility. Recently, it has been shown that the baseline value of Pcrit is helpful in the upfront selection of therapy options. The standard techniques to measure Pcrit are labor-intensive and time-consuming. Therefore, despite the importance of Pcrit, it is not routinely measured in clinical practice. New emerging surrogates, such as finite element (FE) modeling or the use of peak inspiratory flow measurements during a routine overnight polysomnography, may enable clinicians to have an estimate of the pharyngeal collapsibility. However, validation of these techniques is needed.
了解阻塞性睡眠呼吸暂停（OSA）的潜在病理生理学至关重要。上气道可塌陷性是影响OSA上气道的一个重要病理生理因素。本研究的目的是回顾关于OSA中咽可塌陷性的现有知识体系。通过对Medline、PubMed、Scopus和科学网进行全面检索，找到了相关文章并用于本研究。临界关闭压（Pcrit）是衡量咽气道可塌陷程度的金标准。各种生理因素和治疗方法都会影响上气道可塌陷性。最近的研究表明，Pcrit的基线值有助于在治疗方案的初始选择中发挥作用。测量Pcrit的标准技术劳动强度大且耗时。因此，尽管Pcrit很重要，但在临床实践中它并非常规测量项目。新出现的替代方法，如有限元（FE）建模或在常规夜间多导睡眠图期间使用吸气峰流量测量，可能使临床医生能够估计咽可塌陷性。然而，这些技术需要进行验证。
