CT三维重建评估OSAHS患者上呼吸道一期成形术效果

The effects of the plastic operation on upper respiratory tract at one-stage for patients with OSAHS through the assessment of 3-D reconstruction of CT images

目的:以CT扫描三维重建并测量上呼吸道的方法直观并客观地评估多平面阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者上呼吸道一期成形术的成形效果。方法:经PSG检查确诊的OSAHS患者,并以鼻窦、鼻咽部CT加内镜方式确定多平面OSAHS患者上呼吸道的阻塞部位,给予上呼吸道一期成形术。术后再次行鼻窦、鼻咽部CT检查,将上呼吸道手术前后的CT数据三维重建成为立体腔道,直观辨认测量上呼吸道中各狭窄部位,并对比手术前后改变情况。结果:OSAHS患者上呼吸道一期成形术后,症状表现以及PSG检测结果均显示好转,重建上呼吸道后可见其狭窄部位截面积增加超过100%。结论:三维重建数据计算上呼吸道截面积的增加,不仅可在术前客观查找狭窄部位,而且也能够客观评估手术疗效。内镜检查因镜体较大,需要表面麻醉进入鼻腔以及鼻咽,从而会影响上呼吸道狭窄的客观性评估。

Objective：The method of three-dimensional reconstruction of CT images is adopted to evaluate the effects of the plastic operation on upper respiratory tract at one-stage（stage one） for patients with multi-level obstructive sleep apnea hypopnea syndrome. Method： Polysomnography is used to diagnose patients with OSAHS. The obstruction parts of patients with OSAHS are determined by CT and endoscopy examinations in the upper air way. To reconstruct the triimensional cavity of upper respiratory tract from data, the CT examinations on the sinuses and nasopharynx are rescaned to obtain the CT data after surgery. The changed situations before and after surgery are compared, and the narrow parts of the upper respiratory tract can be identified and measured intuitively. Result：Symptoms and PSG test results show that the effects of the surgical results are very good, and the cross sections of upper respiratory tract narrow parts were enlarged by more than 100%. Hydromechanical evidence approved the same results. Conclusion： Calculating the increment of the cross sections of the upper respiratory tract through tri-dimensional reconstruction can not only find the preoperative stenosis, but also assess the surgical effects objectively. Since the body of endoscope has a certain volume, surface anesthesia is needed to enter the nasal cavity and nasopharyngeal which will impact the objectivity of the assessment of the upper respiratory tract stenosis.