Objective:To inquiry the variety difference of upper airway caliber OSAHS sufferer and normal person in quiet respiration Method:Twenty OSAHS sufferer who were viewed by PSG and 16 normal adults who hadve no chief complaint of sleeping disease were selected.The curves of the subjects in a respiratory cycle were recorded by respiratory monitoring system in PSG,while the morphological changes in the harynx of all subjects were observed by fiberscope in a calm respiratory cycle,and then both of the two processes simultaneously were recorded on the same computer.According to the different stages of respiratory cycle by analyzing respiratory curve the video had been edited into pictures about the various anatomical areas in the upper airway,he cross section area and the dimension of palate and lingua and root of the tongue region upper irway wereas studied by the image tools in computer,and the changes of areas and dimensions at palate,and lingua and root of the tongue region upper airway were calculated.Result:It was found that there wasis a morphological change f the upper airway with the respiratory movement in the both groups.The upper airway caliber decrease with inspiration begin and reach the most narrowing at the end of inspiration,then upper airway caliber enlarges with the expiration begin and reach the most widening at the end of expiration.No matter the normal group or the OSAHS roup has the obvious changes in the palate and lingua region on the diameter,the cross section area and the dimension in respiration.The changes in the palate and lingua region on the diameter,the cross section area and the dimension of OSAHS group were greater than normal group.No matter OSAHS group or normal group on the diameter nd cross section area change in the palate was obviously more than the tongue area and the root of tongue area.The changes of OSAHS group on the dimension in the palate were greater than the tongue area and the root of tongue area.Conclusion:There are periodically changes of upper airway during respiration cycle in normal adults and SAHS patients.The effects of respiration on upper airway caliber of OSAHS patients are more obviously than normal adults.and the increasing effects in OSAHS patients is one of OSAHS etiology.

OBJECTIVE To summarize and evaluate the therapeutic studies on obstructive sleep apnea-hypopnea syndrome(OSAHS)in our country. METHODS Articles of therapeutic studies on OSAHS published in major journals of our country from Jan. 1995 to Dec. 2004 were evaluated retrospectively. RESULTS A total of 201 articles were recruited. The number of articles published every year was increased with time and most of the articles were retrospective study. There were no standard criteria for evaluating the curative effect,and the cure rate of UPPP were obviously different according to different evaluation criteria. In same evaluation criteria,the short- term outcome were better than long-term outcome,and the patients underwent multiple levels surgery had better outcome than single UPPP. CONCLUSION Multi-center,large sampled and prospective random comparison therapeutic study based on evaluative criteria constituted by Chinese Medical Association should be carried out in the future study. The impersonal methods and criteria for evaluation the upper airway anatomic structure and pharyngeal wall resilience should be established. Individuality therapy should be done. And finally, bring on therapeutic effect of OSAHS to a higher level in our country.

OBJECTIVE: To inquiry the variety difference of upper airway caliber OSAHS sufferer and normal person in quiet respiration. METHOD: Twenty OSAHS sufferer who were viewed by PSG and 16 normal adults who hagve no chief complaint of sleeping disease were selected. The curves of the subjects in a respiratory cycle were recorded by respiratory monitoring system in PSG, while the morphological changes in the pharynx of all subjects were observed by fiberscope in a calm respiratory cycle, and then both of the two processes simultaneously were recorded on the same computer. According to the different stages of respiratory cycle by analyzing respiratory curve the video had been edited into pictures about the various anatomical areas in the upper airway, the cross section area and the dimension of palate and lingua and root of the tongue region upper airway whereas studied by the image tools in computer, and the changes of areas and dimensions at palate, and lingua and root of the tongue region upper airway were calculated. RESULT: It was found that there wasps a morphological change of the upper airway with the respiratory movement in the both groups. The upper airway caliber decrease with inspiration begin and reach the most narrowing at the end of inspiration, then upper airway caliber enlarges with the expiration begin and reach the most widening at the end of expiration. No matter the normal group or the OSAHS group has the obvious changes in the palate and lingua region on the diameter, the cross section area and the dimension in respiration. The changes in the palate and lingua region on the diameter, the cross section area and the dimension of OSAHS group were greater than normal group. No matter OSAHS group or normal group on the diameter and cross section area change in the palate was obviously more than the tongue area and the root of tongue area. The changes of OSAHS group on the dimension in the palate were greater than the tongue area and the root of tongue area. CONCLUSION There are periodically changes of upper airway during respiration cycle in normal adults and OSAHS patients. The effects of respiration on upper airway caliber of OSAHS patients are more obviously than normal adults, and the increasing effects in OSAHS patients is one of OSAHS etiology.
Adult ; Case-Control Studies ; Humans ; Male ; Middle Aged ; Palate ; anatomy & histology ; pathology ; Palate, Soft ; anatomy & histology ; pathology ; Pharynx ; anatomy & histology ; pathology ; Respiration ; Respiratory System ; Sleep Apnea, Obstructive ; pathology ; physiopathology ; Tongue ; anatomy & histology ; pathology

OBJECTIVE: To study the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and insulin resistance (IR), then evaluate the effectiveness of the improved Uvulopalatopharyngoplasty (MUPPP) and continuous positive airway pressure (CPAP) on IR. METHOD: Fourteen patients of OSAHS were treated by MUPPP, and sixteen patients of OSAHS were treated by CPAP. All index of the nocturnal polysomnography, fasting plasma insulin, fasting plasma glucose, insulin and blood sugar of 2 hours after meal were analyzed before and after therapy, and 10 patients of OSAHS were untreated by MUPPP or CPAP. The other 33 cases of non-OSAHS were selected as control group. According to the model of HOMA and the formula of LiGuangwei,insulin resistance index and insulin sensitivity index were calculated, respectively. RESULT: There were significant differences between OSAHS group before treatment and control group, before and after treatment, after treatment and untreated group (P < 0.01 or P < 0.05). There was very significant correlation between IAI and LSaO2 (r = 0.633),and there was significantly negative correlation between IAI and AHI (r = -0.654). CONCLUSION OSAHS is an important risk factor for the development of insulin resistance. It shows that OSAHS may develop IR of the patients and the treatment of MUPPP and CPAP can improve insulin sensitivity.
Adult ; Blood Glucose ; metabolism ; Continuous Positive Airway Pressure ; Female ; Humans ; Insulin ; blood ; Insulin Resistance ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; Palate ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; metabolism ; physiopathology ; surgery ; therapy ; Uvula ; surgery

OBJECTIVETo compare the lingual region upper airway CT scan results of OSAS patients and normal adults to explore if there are upper airway stricture in OSAS patients and the reason of stricture.

METHODS59 patients with OSAS and 57 normal adults were included in the study. CT evaluated the lingual region upper airway with the use of a Philips Tomoscan AV Expander E1 spiral scanner. The shapes of lingual region upper airway were observed. The area and the dimensions of lingual region was studied, and the thickness of retropharyngeal and lateral pharyngeal tissue were evaluated too. The another focus area was tongue, and the evaluated data included the tongue width, genioglossus width, hyogolssus width, tongue length and tongue area.

RESULTSThe data comparative results of OSAS and normal groups were as follows: the right to left diameter and area of OSAS patients' lingual region upper airways were less than those of normal adults, the thickness of lateral pharyngeal, tongue width, genioglossus width, hyogolssus width and tongue area were more than those of normal adults. And there were not obviously difference between OSAS patients and normal adults in tongue length, anterior-to-posterior dimension and thickness of retropharyngeal wall tissue of upper airway.

CONCLUSIONSThe study suggests that there are obviously difference between the patients with OSAS and normal adult in lingual upper airway CT scan measure. And the anatomic stricture of lingual upper airway is one of the etiology of OSAS. The main reasons of stricture are increasing of thickness of lateral pharyngeal, tongue width, genioglossus width, hyogolssus width and tongue area.

Adult ; Female ; Humans ; Male ; Middle Aged ; Pharynx ; diagnostic imaging ; Sleep Apnea, Obstructive ; diagnostic imaging ; Tomography, X-Ray Computed ; methods ; Tongue ; diagnostic imaging

OBJECTIVE: To observe the effects of pressure level in veil on upper airway in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and normal adults. METHOD: We scanned the upper airway from roof of nasopharynx to glottis with SIMENS 16 layer spiral CT scanner. The area and the dimensions of palate, uvula, and the region after lingua and epiglottis were measured by application of image work station. Forty-six patients with OSAHS and 35 normal adults were scanned by CT at 0 kPa water column and 0.784 kPa water column pressures in face mask, respectively. RESULT: The area and inner diameter of OSAHS patients upper airways were less than those of normal adults at the same pressure in face mask. The area and inner diameter of upper airway at the pressure of 0.784 kPa water column were more than those at 0 kPa water column in both OSAHS patients and normal adults, and the increased extent of normal adults were more than those of OSAHS patients. We measured the minimum increased normal Cross sectional area of palate, uvula, and the region after lingua and epiglottis when the pressure in the mask increased from 0 kPa to 0.784 kPa, and we made it as the standard. The 46 OSAHS patients were sorted into 17 cases (group 1) with normal dilation and 29 cases (group 2) with less dilation in such standard. There was not significant difference between the two groups at 0 kPa pressures in area and inner diameter, but the area and inner diameter of group 1 were more than those of group 2 at 0.784 kPa pressure. CONCLUSION The increased pressure in face mask would lead to upper airway dilation both in OSAHS patients and normal adults, and the dilated extents of normal adults were significant more than those of OSAHS patients. The less dilation of OSAHS may be duo to anatomic constriction and some pharynx wall pathological changes.
Adolescent ; Adult ; Case-Control Studies ; Female ; Humans ; Male ; Masks ; Middle Aged ; Palate ; diagnostic imaging ; Pharynx ; diagnostic imaging ; Pressure ; Sleep Apnea, Obstructive ; diagnostic imaging ; physiopathology ; Tomography, X-Ray Computed ; Tongue ; diagnostic imaging ; Uvula ; diagnostic imaging ; Young Adult

Objective To explore the effect of head acupuncturing therapy combined with massaging key head acupoints on language and cognitive function in children with autism.Methods 60 children with autism who visited the Department of Pediatric Rehabilitation of our hospital from January 2021 to June 2022 were selected as subjects,who were then randomly divided into the conventional group treated with the conventional rehabilitation training and the combination group treated with head acupuncturing therapy combined with massaging the key acu-points,apart from conventional rehabilitation training 30 cases in each group.The cognitive function,developmental status,and parental quality of life before and after the treatment were compared between the two groups,and so were the language function and safety.Results There were no significant differences in the scores by Autism Behavior Checklist(ABC)and Childhood Autism Rating Scale(CARS),adaptability scores,language scores,and individual-social interaction scores between the conventional group and the combination group before the treatment(P>0.05).After the treatment,the scores by ABC and CARS were significantly decreased in both groups,and the scores of the combination group were significantly lower than those in the conventional group(P<0.05);The adaptability scores,language,individual-social interaction scores were significantly increased in both groups,and the scores of the combined group were significantly higher than those of the conventional group(P<0.05).The abnormal rates of symbolic expression,language comprehension,action-oriented subjects,and language development delay in the combined group were all significantly lower than those in the conventional group(P<0.05).There was no significant difference in the scores by the QL-Index between the conventional group and the combined group before the treatment(P>0.05),but after the treatment,the QL-Index scores of the conventional group and the combination group were increased,and the score of the combination group was significantly higher than that of the conventional group(P<0.05).The results of blood routine,urine routine,stool routine,liver function,and kidney function in both groups were not significantly abnormal.There was one case of mild swelling and pain at the acupunctured site in the combination group,which was improved without intervention.Conclusion Head acupuncturing therapy combined with massaging the key head acupoints can improve language function,cognitive function,and development of autis-tic children.In addition,it can enhance parental quality of life and have a high level of safety.

OBJECTIVETo explore investigate the feasibility of transoral removal of macrosis benign neoplasms in parapharyngeal space.

METHODSSixteen patients with well-defined macrosis benign parapharyngeal space tumors treated by surgery from January 2005 to December 2012 were enrolled in this study. All patients were assessed by CT scan, MRI and CT angiography before surgery. Surgery for the tumors with complete peplos, locating at medial side of carotid and accessible from the oropharynx was completed with the assistance of endoscope, bipolar electrocoagulation or radiofrequency ablation system.

RESULTSAll neoplasms were removed by transoral approach. Tracheotomy was performed in 4 cases. All patients were treated successfully with good postoperative recovery and no significant complications. Postoperative pathological examination showed there were 9 cases of pleomorphic adenoma, 5 cases of neurilemmoma and 2 cases of neurofibroma. By the follows-up of 1-8 years (median 31 months), among 16 cases only one case of neurofibroma recurred.

CONCLUSIONThe transoral removal of macrosis benign neoplasms in parapharyngeal space is safe, manimally invasive and feasible in selected cases, with a high local control rate and a low surgical complication rate.

Adenoma, Pleomorphic ; Angiography ; Brain Neoplasms ; Humans ; Magnetic Resonance Imaging ; Neoplasm Recurrence, Local ; Neoplasms ; Neurilemmoma ; Neurofibroma ; Oropharynx ; Pharyngeal Neoplasms ; surgery ; Pharynx ; Postoperative Period ; Retrospective Studies ; Tomography, X-Ray Computed