Mochizuki T
Department of Otolaryngology, Kitasato University, School of Medicine.
Nihon Jibiinkoka Gakkai Kaiho. 1997 Sep;100(9):937-45. doi: 10.3950/jibiinkoka.100.937.
In order to clarify morphological abnormalities of the upper airway in patients with obstructive sleep apnea syndrome (OSAS), and to predict the severity as well as the effect of surgery, we statistically examined the relationship between the degree of low palatal arch and the result of cephalometry in 45 adult male patients with OSAS who underwent uvulopalatopharyngoplasty. The patients were divided into 3 types, A, B and C, according to the degree of low palatal arch on inspection, and type C was regarded as having a low palatal arch with a long low-hanging soft palate. It was found that (1) type C patients showed a higher preoperative apnea index and lower minimal blood oxygen saturation, suggesting a serious condition. (2) In type C patients, the long axis (PNS-H) of the airway was larger, and the oral area was smaller. The area of the entire tongue, especially the upper half of the tongue, was larger than that in patients of other types. Type C patients were further divided into 3 subtypes: (1) those with a substantially long low-hanging soft palate; (2) those with a long low-hanging soft palate and large tongue; and (3) those in whom the large tongue is the main factor for the apparent low-hanging soft palate. These subtypes should be confirmed by cephalography before treatment for effective surgical results.
为了阐明阻塞性睡眠呼吸暂停综合征（OSAS）患者上气道的形态异常，并预测手术的严重程度及效果，我们对45例接受悬雍垂腭咽成形术的成年男性OSAS患者，就低腭弓程度与头影测量结果之间的关系进行了统计学检验。根据检查时低腭弓的程度，将患者分为A、B、C 3型，C型被视为具有低腭弓且软腭低垂较长。结果发现：（1）C型患者术前呼吸暂停指数较高，最低血氧饱和度较低，提示病情严重。（2）C型患者气道的长轴（PNS-H）较大，口腔面积较小。整个舌头的面积，尤其是舌的上半部分，比其他类型患者的更大。C型患者进一步分为3个亚型：（1）软腭低垂相当长的患者；（2）软腭低垂较长且舌头较大的患者；（3）大舌头是导致软腭明显低垂的主要因素的患者。为获得有效的手术效果，这些亚型在治疗前应通过头颅造影进行确认。
