Friberg D, Gazelius B
Department of Otorhinolaryngology, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden.
Acta Otolaryngol. 1998 Jun;118(3):413-8. doi: 10.1080/00016489850183539.
The patency of the upper airways during inspiration is maintained by reflexogenic muscular dilation, mediated by afferent nerves. Our hypothesis is that a local disturbance in these nerves might explain the increased tendency of upper airways to collapse in patients with obstructive sleep apnea. The vascular reaction in the mucosal microcirculation is regulated by afferent nerves. To investigate this, we developed the laser Doppler perfusion monitoring method and electrical nerve stimulation for investigations of the soft palatal mucosa in non-snoring subjects. A 12 cm probe with integrated bipolar electrodes and a special probe-holder were designed. The bandwidths 12 and 24 kHz were compared and the latter was better able to detect a high blood-flow. A dose response relation was found between the voltage stimulation level and percentage increase in blood-flow. Three series of stimuli (40 V) in 10 subjects caused reproducible vascular reactions. In conclusion, this method seems to be safe, tolerable and valuable for investigations of patients with obstructive sleep apnea or other pharyngeal disorders, e.g. dysphagia, in the search for local nerve lesions.
吸气时上呼吸道的通畅是由传入神经介导的反射性肌肉扩张来维持的。我们的假设是，这些神经的局部紊乱可能解释了阻塞性睡眠呼吸暂停患者上呼吸道塌陷倾向增加的原因。黏膜微循环中的血管反应受传入神经调节。为了对此进行研究，我们开发了激光多普勒灌注监测方法和电神经刺激法，用于对非打鼾受试者的软腭黏膜进行研究。设计了一个带有集成双极电极的12厘米探头和一个特殊的探头支架。对12千赫和24千赫的带宽进行了比较，发现后者能更好地检测到高血流量。在电压刺激水平和血流量增加百分比之间发现了剂量反应关系。对10名受试者进行的三组刺激（40伏）引起了可重复的血管反应。总之，这种方法对于阻塞性睡眠呼吸暂停或其他咽部疾病（如吞咽困难）患者寻找局部神经病变的研究似乎是安全、可耐受且有价值的。
