Evaluation of retropalatal mechanical loads in patients with obstructive sleep apnea
10.3760/cma.j.issn.1673-0860.2009.10.010
- VernacularTitle:完全肌松状态下阻塞性睡眠呼吸暂停患者上气道塌陷性的评估
- Author:
Yan-Ru LI
1
;
Jing-Ying YE
;
Tian-Zuo LI
;
Na LIN
Author Information
1. 首都医科大学附属北京同仁医院
- Keywords:
Sleep apnea;
obstructive;
Pharyngeal muscles;
Muscle relaxation;
Pressure
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2009;44(10):819-824
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the mechanical load of retrupalatal airway in obstructive sleep apnca patients, and to investigate the contributions of pharyngeal anatomy to upper airway collapsibility. Methods Static mechanical load of transpalatal pharynx was determined by opening pressure (Popen) of the segment during general anesthesia in 30 patients and 14 controls. Size of pharynx was measured while intraluminal pressure was controlled at 3-20 cm H_2O( 1 cm H_2O=0.09806 kPa) and the minimal intraluminal pressure that needed to compensate for the mechanical load of a retropalatal segment was determined. Results Pharyngeal cavity collapse at the level of the hard palate was observed in only one of the 30 subjects (3.3%), and in none of the 14 controls. At tongue base level, 23 subjects had a Popen >0 cm H_2O(76.7%) while in 7 of the controls (50.0%) had a Popen >0 cm H_2O. And at the level of the uvual and soft palate, pharyngeal collapses was observed in all subjects except in 9 of the controls (64.3%). The median of Popen was 8.3 [5.9; 11.5] cm H_2O in the patients group and was 2. 7 [-3.9; 6.0]cm H_2O in the control group. Differences of Popen were siguifcant between patients and controls(U= 58.500,P=0.000). The correlation between Popen and AHI was also significant at 0. 05 level (r=0.377, P=0.044). Conclusions Patients with sleep apnea have more collapsible passive upper airway than controls. Retropalatal and retroglossal airway are the most collapsible segments and positive pressures are needed to compensate for the mechanical loads.
