腭咽环扎术后阻塞性睡眠呼吸暂停低通气综合征上气道形态的研究

Upper airway morphology of patients with obstructive sleep apnea hypopnea syndrome after velopharyngeal ring ligation procedure

目的:探讨腭咽环扎术(VRLP)后阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的上气道形态特征。方法:应用纤维鼻咽镜和头影测量技术检查了6例VRLP后并发OSAHS患者、6例VRLP后未发生OSAHS和6例未手术腭裂患者的上气道形态,测量了鼻咽腔直径、腭咽环扎处咽腔直径、口咽腔直径、舌根后咽腔直径、下咽腔直径、舌骨至下颌骨的距离等6个相关参数,并应用单因素方差分析进行组间比较。结果:未手术腭裂患者上气道形态光滑,VRLP后上气道在软腭后区和舌根后区出现2处狭窄,VRLP后OSAHS患者上气道鼻咽部明显狭窄变形,为腺样体肥大所致。结论:X线头影测量技术是一种简单实用的评估VRLP后OSAHS的方法,建议VRLP术前行此检查以排除腺样体严重增生患者。

Objective： To study the upper airway morphologic changes in patients with obstruc- tire sleep apnea hypopnea syndrome （OSAHS） after velopharyngeal ring ligation procedure （VRLP）. Methods： Upper airway morphology was tested by fibre-optic nasopharyngoscope and cephalometry in 6 cases of OSAHS accured after VRLP, 6 cases without OSAHS after VRLP and 6 cases non-operated for length from UPW to PNS, from RPW to SP, from MPW to U, from PT to postbase, from LPW to V, and from AH to MP. Oneway ANOVA was used to determine if there were statistical differences between the groups. Results： Upper airway morphology of non-operated cleft palates was smooth, as well as two strictures were found at retropalatal region and retroglossal region in patients without OSAHS after VRLP. Remarkable narrow nasopharyngeal meatus was found in patients with OSAHS after VRLP mainly because of adenoidal hypertrophy. Conclusion： Cephalometry is a simole and useful wav in diagnosis of OSAHS after VRLP and is recommended before VRLP to exclude patients with serious adenoidal hypertrophy.