Sériès F, St Pierre S, Carrier G
Centre de Pneumologie, Hôpital Laval, Québec G1V 4GS, Canada.
Thorax. 1993 Apr;48(4):360-3. doi: 10.1136/thx.48.4.360.
A study was undertaken to determine if cephalometric radiographs could identify those who will benefit from nasal surgery in patients with a sleep apnoea hypopnoea syndrome (SAHS) and chronic nasal obstruction.
Fourteen patients with SAHS were enrolled. Those with normal posterior airway space and mandibular plane to hyoid bone distances on preoperative cephalometric radiographs were matched with those with abnormal cephalometry for the frequency of sleep disordered breathing and body mass index. Polysomnographic studies (all subjects) and nasal resistance measurements (n = 10) were performed one to three months before and two to three months after surgery (septoplasty, turbinectomy, and polypectomy).
There was no difference in the baseline results of the polysomnographic studies between the two groups of patients. Nasal resistance decreased from a mean (SE) value of 2.9 (0.3) cm H2O/l/s before surgery to 1.4 (0.1) cm H2O/l/s after surgery in the normal cephalometry group and from 2.7 (0.3) cm H2O/l/s to 1.3 (0.3) cm H2O/l/s in the other group. The apnoea + hypopnoea index returned to normal (< 10 breathing abnormalities/hour) in all but one subject with normal cephalometric measurements, and sleep fragmentation improved with a decrease in the arousal index from 23.9 (3.3)/hour at baseline to 10.6 (2.5)/hour after surgery. Both of these parameters remained unchanged after surgery in the patients with abnormal cephalometry.
Normal cephalometry is helpful in identifying patients with mild SAHS and nasal obstruction who will benefit from nasal surgery. The presence of craniomandibular abnormalities makes it unlikely that nasal surgery will improve sleep related breathing abnormalities.
开展了一项研究，以确定头影测量X线片能否识别出睡眠呼吸暂停低通气综合征（SAHS）和慢性鼻阻塞患者中那些将从鼻腔手术中获益的人。
招募了14例SAHS患者。将术前头影测量X线片显示后气道间隙和下颌平面至舌骨距离正常的患者与头影测量异常的患者在睡眠呼吸紊乱频率和体重指数方面进行匹配。在手术（鼻中隔成形术、鼻甲切除术和鼻息肉切除术）前1至3个月和术后2至3个月进行多导睡眠图研究（所有受试者）和鼻阻力测量（n = 10）。
两组患者多导睡眠图研究的基线结果无差异。正常头影测量组的鼻阻力从术前的平均（标准误）值2.9（0.3）cmH₂O/l/s降至术后的1.4（0.1）cmH₂O/l/s，另一组从2.7（0.3）cmH₂O/l/s降至1.3（0.3）cmH₂O/l/s。除一名头影测量正常的受试者外，所有受试者的呼吸暂停+低通气指数均恢复正常（<10次呼吸异常/小时），睡眠片段化得到改善，觉醒指数从基线时的23.9（3.3）/小时降至术后的10.6（2.5）/小时。头影测量异常的患者术后这两个参数均未改变。
正常头影测量有助于识别轻度SAHS和鼻阻塞且将从鼻腔手术中获益的患者。颅下颌异常的存在使得鼻腔手术不太可能改善与睡眠相关的呼吸异常。
