Rodriguez Alcala Cristina, Rodriguez Alcala Laura, Ignacio Garcia Jose Maria, Plaza Guillermo, Baptista Peter, Lujan Guillermina, Mazzei Paula, Ibañez-Rodriguez Juan Antonio, O'Connor-Reina Carlos
Anesthesiology Department, Hospital Quironsalud Marbella, 29680 Marbella, Spain.
Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29680 Marbella, Spain.
Life (Basel). 2024 Jan 30;14(2):197. doi: 10.3390/life14020197.
The anatomy of the upper airways influences the risk of obstructive sleep apnea (OSA). The size of soft tissue structures, such as the tongue, soft palate, and lateral walls of the pharynx, contributes to the pathogenesis of OSA. New lines of treatment for sleep apnea, such as myofunctional therapy (MT), aim to strengthen the oropharyngeal musculature to improve the defining parameters of apnea. The present protocol uses ultrasound imaging to measure the size of the lingual musculature non-invasively and cost-effectively and evaluates the changes in its morphology. Eligible patients include those with OSA who have undergone submental cervical ultrasound and drug-induced sleep endoscopy before starting MT with the AirwayGym app. Follow-up evaluations are conducted at 3 months after beginning treatment. Patients diagnosed with OSA via questionnaires and polysomnography or respiratory polygraphy are evaluated anatomically and functionally using the Iowa Oral Performance Instrument, a tongue digital spoon, somnoscopy, and submental cervical ultrasound to assess their responses to the AirwayGym app. The lingual thickness (mm) and volume (cm) and the distance between both lingual arteries (mm) are measured. The AirwayGym app helps users and therapists monitor the patient performance of MT. Incorporating submental ultrasound can be a useful non-invasive tool to evaluate OSA and MT.
上呼吸道的解剖结构会影响阻塞性睡眠呼吸暂停（OSA）的风险。软组织结构的大小，如舌头、软腭和咽侧壁，在OSA的发病机制中起作用。睡眠呼吸暂停的新治疗方法，如肌功能治疗（MT），旨在增强口咽肌肉组织，以改善呼吸暂停的定义参数。本方案使用超声成像以无创且经济高效的方式测量舌肌组织的大小，并评估其形态变化。符合条件的患者包括那些在开始使用AirwayGym应用程序进行MT治疗之前已接受颏下颈部超声检查和药物诱导睡眠内镜检查的OSA患者。在开始治疗3个月后进行随访评估。通过问卷、多导睡眠图或呼吸多导仪诊断为OSA的患者，使用爱荷华口腔功能仪器、舌数字勺、睡眠镜检查和颏下颈部超声进行解剖学和功能评估，以评估他们对AirwayGym应用程序的反应。测量舌厚度（mm）、体积（cm）以及两条舌动脉之间的距离（mm）。AirwayGym应用程序可帮助用户和治疗师监测患者的MT表现。纳入颏下超声检查可成为评估OSA和MT的有用无创工具。
