Smith P L, Eisele D W, Podszus T, Penzel T, Grote L, Peter J H, Schwartz A R
Johns Hopkins University Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA.
Sleep. 1996 Dec;19(10 Suppl):S284-7.
Investigators have postulated that pharyngeal collapse during sleep in patients with obstructive sleep apnea (OSA) may be alleviated by stimulating the genioglossus. The effect of electrical stimulation (ES) of the genioglossus on pharyngeal patency was examined in an isolated feline upper airway preparation and in apneic humans during sleep. We found that stimulation of the genioglossus (n = 8) and of the hypoglossal nerve (n = 1) increased maximum airflow through the isolated feline upper airway in humans during sleep. Additional findings in the isolated feline upper airway suggest that such increases in airflow were due to decreases in pharyngeal collapsibility. The evidence suggests that improvements in airflow dynamics with electrical stimulation are due to selective recruitment of the genioglossus, rather than due to nonspecific activation of the pharyngeal musculature or arousal from sleep. The implications of these results for future therapy with ES are discussed.
研究人员推测，通过刺激颏舌肌，可缓解阻塞性睡眠呼吸暂停（OSA）患者睡眠期间的咽部塌陷。在分离的猫科动物上呼吸道标本以及睡眠中的呼吸暂停患者中，研究了颏舌肌电刺激（ES）对咽部通畅性的影响。我们发现，刺激颏舌肌（n = 8）和舌下神经（n = 1）可增加睡眠中人类分离的猫科动物上呼吸道的最大气流。在分离的猫科动物上呼吸道中的其他发现表明，气流的这种增加是由于咽部可塌陷性的降低。有证据表明，电刺激引起的气流动力学改善是由于颏舌肌的选择性募集，而非咽部肌肉组织的非特异性激活或睡眠唤醒。讨论了这些结果对未来ES治疗的意义。
