2.The impact of nasal obstruction on OSAHS.
Huabin ZHU ; Yunhai FENG ; Chunhong ZHAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2010;24(12):547-548
OBJECTIVE:
To evaluate the impact of nasal obstruction on OSAHS.
METHOD:
One hundred and twenty cases of OSAHS with or without nasal obstruction were analyzed by Hypno PTT(PTT)and Mallampati score (MS); Acoustic rhinometry was measured in all 120 cases.
RESULT:
A significant correlation was found between the MS and the AHI measured during the sleep (r = 0.266, P < 0.01). The relative risk of OSAHS with a MS of III or IV in the whole group was 1.96, and 2.46 in cases with nasal obstruction.
CONCLUSION
A high MS represents a predisposing factor for OSAHS, especially in which associated with nasal obstruction.
Humans
;
Nasal Obstruction
;
complications
;
diagnosis
;
pathology
;
Rhinometry, Acoustic
;
Sleep Apnea, Obstructive
;
complications
;
diagnosis
;
pathology
;
Tongue
;
pathology
4.Diagnosis and treatment of retroglossal stenosis.
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2006;41(11):874-877
Constriction, Pathologic
;
diagnosis
;
pathology
;
therapy
;
Humans
;
Palate, Soft
;
pathology
;
Sleep Apnea, Obstructive
;
diagnosis
;
pathology
;
therapy
;
Tongue
;
pathology
;
Uvula
;
pathology
5.The analysis of correlation between tongue body MRI and upper airway pressure measurements of blocked lingual region in patients with moderate and severe OSAHS.
Guofeng XIONG ; Jianwen HU ; Weijun CHEN ; Yimin ZENG ; Wenlong ZHENG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(21):1853-1856
OBJECTIVE:
To investigate the correlation between tongue body MRI measurements and the lingual region obstruction in patients with obstructive sleep apnea hypopnea syndrome (obstructive sleep apnea hypopnea syndrome, OSAHS), and the relationship of two diagnosis methods in positioning obstructive level, in order to improve the preoperative diagnostic accuracy of obstructive level in OSAHS patients .
METHOD:
Fifty-nine patients with OSAHS definited by the AG200 sleep apnea monitoring and obstruction plane positioning system was included. They all underwent tongue MRI scan, after three-dimensional reconstruction, the tongue body length to diameter, relative thickness, basal diameter, wide around central about wide diameter and tongue body volume were measured. The lower blocking (mainly composed of lingual region) constituent ratio P established by AG200 was correlated with tongue parameters measured by MRI. At the same time, To analysis of differences of P in patients with different degree of OSAHS.
RESULT:
Among these patients with OSAHS in different degree, the coefficient correlation between tongue parameters(tongue length, relative thickness, basal diameter, wide middle diameter, tongue body volume) and lower blocking constitute ratio P werer LP = 0.051,rHP = 0.069, r1 = 0.215, r2 = 0.147, rVP = 0.259, respectively. lower obstruction of form than the differences had statistical significance. The measured tongue parameters and value P(the lower blocking constituent ratio) were negatively correlated, which demonstrated that exclusing of the larynx and hypopharynx airway obstruction, the lower airway obstruction detected by AG200 was related with tongue parameters measured by MRI, and was strongestly related with the tongue body volume.
CONCLUSION
The volume of tongue and AG had correlation in judgement of lower blocking. In OSAHS patients the lower blocking constituent ratio varies between the defferent severity groups of the disease, the combina tion of the two method can be used to predict the obstructive plane in OSAHS patients with upper airway obstruction, and provide the basis for the individual treatment of patients with OSAHS.
Airway Obstruction
;
complications
;
Humans
;
Imaging, Three-Dimensional
;
Magnetic Resonance Imaging
;
Sleep
;
Sleep Apnea, Obstructive
;
diagnosis
;
Tongue
;
pathology
6.Children severe OSAHS with pectus excavatum: a case report.
Wei MA ; Jinfeng WANG ; Yuping XIE
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2016;30(5):407-409
The primary etiopathology of pediatric OSAHS includes tonsil or adenoid hypertrophy. Severe OSAHS contributes to or aggravates thoracic deformity, which is rarely reported. In the current report, This children sleep snoring more than 4 years, increasing with thoracic severe depression during sleep 2 days. Clinical examination indicated tonsil and adenoid hypertrophy, and polysomnography revealed OSAHS . The symptoms of OSAHS and severe inhalation-related sternum depression disappeared rapidly after tonsillectomy. Our findings indicated that OSAHS were the major causes underlying funnel chest in children. The rarity of the incidence may result in missed diagnosis or misdiagnosis. Polysomnography was recommended for the child diagnosed with funnel chest accompanied by upper airway stenosis.
Adenoids
;
pathology
;
Child
;
Funnel Chest
;
diagnosis
;
Humans
;
Hypertrophy
;
Palatine Tonsil
;
pathology
;
Polysomnography
;
Sleep Apnea, Obstructive
;
diagnosis
;
Snoring
;
Tonsillectomy
7.One case of pediatric obstructive sleep apnea hypopnea syndrome with pulmonary hypertension.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(7):664-665
The clinical manifestation included snoring and mouth breathing for 2 years, repeated coughing and shortness of breath in action for more than 1 year. Physical examination of oral cavity showed tonsils were in grade III. The endoscopy showed 2/3 of postnaris were blocked by the adenoids. The preoperative ultrasonic cardiogram revealed the right atrial and right ventricular dilatation, pulmonary artery widened. The preoperative polysomnography (PSG) showed apnea-hypopnea index (AHI) was 28.5 events an hour, and the lowest oxygen saturation (LSaO2) was 39%. The patient was diagnosed as severe obstructive sleep apnea hypopnea syndrome with pulmonary hypertension. The postoperative PSG showed the AHI was 11.7 events an hour, and the LSaO2 was 86%. The ultrasonic cardiogram at 5 months after surgery didn't show any abnormalities.
Adenoids
;
pathology
;
Child
;
Cough
;
Humans
;
Hypertension, Pulmonary
;
complications
;
diagnosis
;
Palatine Tonsil
;
pathology
;
Polysomnography
;
Sleep Apnea, Obstructive
;
complications
;
diagnosis
;
Snoring
8.Correlation between the Severity of Obstructive Sleep Apnea and Heart Rate Variability Indices.
Doo Heum PARK ; Chul Jin SHIN ; Seok Chan HONG ; Jaehak YU ; Seung Ho RYU ; Eui Joong KIM ; Hong Beom SHIN ; Byoung Hak SHIN
Journal of Korean Medical Science 2008;23(2):226-231
The risk of cardiovascular disease is known to be increased in obstructive sleep apnea syndrome (OSAS). Its mechanism can be explained by the observation that the sympathetic tone increases due to repetitive apneas accompanied by hypoxias and arousals during sleep. Heart rate variability (HRV) representing cardiac autonomic function is mediated by respiratory sinus arrhythmia, baroreflexrelated fluctuation, and thermoregulation-related fluctuation. We evaluated the heart rate variability of OSAS patients during night to assess their relationship with the severity of the symptoms. We studied overnight polysomnographies of 59 male untreated OSAS patients with moderate to severe symptoms (mean age 45.4+/- 11.7 yr, apnea-hypopnea index [AHI]=43.2+/-23.4 events per hour, and AHI >15). Moderate (mean age 47.1+/-9.4 yr, AHI=15-30, n=22) and severe (mean age 44.5 +/-12.9 yr, AHI >30, n=37) OSAS patients were compared for the indices derived from time and frequency domain analysis of HRV, AHI, oxygen desaturation event index (ODI), arousal index (ArI), and sleep parameters. As a result, the severe OSAS group showed higher mean powers of total frequency (TF) (p=0.012), very low frequency (VLF) (p= 0.038), and low frequency (LF) (p=0.002) than the moderate OSAS group. The LF/HF ratio (p=0.005) was higher in the severe group compared to that of the moderate group. On the time domain analysis, the HRV triangular index (p=0.026) of severe OSAS group was significantly higher. AHI was correlated best with the LF/HF ratio (r(p)=0.610, p<0.001) of all the HRV indices. According to the results, the frequency domain indices tended to reveal the difference between the groups better than time domain indices. Especially the LF/HF ratio was thought to be the most useful parameter to estimate the degree of AHI in OSAS patients.
Adult
;
Cardiovascular Diseases/*diagnosis/pathology
;
Electrocardiography/methods
;
*Heart Rate
;
Humans
;
Male
;
Middle Aged
;
Oximetry
;
Oxygen/metabolism
;
Plethysmography
;
Polysomnography/methods
;
Sleep
;
Sleep Apnea, Obstructive/*diagnosis/pathology
9.Dynamic imaging assessment on the upper airway in patients with obstructive sleep apnea hypopnea syndrome.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2012;26(8):381-384
It is vital to make an individual plan for each patient with obstructive sleep apnea-hypopnea syndrome (OSAHS) according to the obstruction sites. The high resolution anatomical information of upper airway and soft tissue can be obtained, especially by MRI and CT scans. Dynamic and state-dependent imaging techniques are beneficial to study stereo changes of anatomy and morphology of upper airway in quiet breathing, sleeping or airway closure. Although dynamic imaging examination has value in diagnosis and treatment of OSAHS, there has no uniform position diagnosis standard. This article reviews the history of dynamic imaging study on OSAHS, the advantages and disadvantages of various imaging technologies and prospects of imaging position diagnosis.
Humans
;
Magnetic Resonance Imaging
;
Respiratory System
;
diagnostic imaging
;
pathology
;
Sleep Apnea, Obstructive
;
diagnosis
;
diagnostic imaging
;
Tomography, X-Ray Computed
10.Suggestions on the diagnostic criteria of childhood obstructive sleep apnea hypopnea syndrome.
Xu QIN ; Aihuan CHEN ; Email: CHAIH163@163.COM. ; Lihong SUN ; Jiaying LUO ; Shunkai HUANG ; Lijun ZENG ; Fanglue ZHOU
Chinese Journal of Pediatrics 2015;53(7):528-531
OBJECTIVETo evaluate the sleep architecture and hypoxia and clinical features of habitual snoring children with an obstructive sleep apnea-hypopnea index (OAHI) 1 to 5.
METHODThe polysomnographic data of 267 children aged from 2 to 16 years with habitual snoring were analyzed retrospectively, and the clinical features were analyzed in 108 of the children. The recruited children were divided into primary snoring group (PS group, OAHI≤1), obstructive sleep apnea hypopnea syndrome (OSAHS) group (1
RESULTThe oxygen desaturation index of the intermediate OSAHS group (3.8±0.4) was significantly higher than that of PS group (1.6±0.1) (χ2=34.5, P<0.01). The LSpO2 of intermediate OSAHS group was significantly lower than that of PS group (89(87,91) vs. 93(91,94), χ2=40.2, P<0.01). Comparing to the PS group, the non-rapid eye movement 1 ratio (N1%) was significantly higher (19.0±1.2 vs. 14.2±0.1, χ2=14.1, P<0.01), and the non-rapid eye movement 3 ratio (N3%) was significantly lower (24.4±1.0 vs. 29.0±1.1, P<0.01) in the intermediate OSAHS group. The pediatric questionnaire score intermediate OSAHS group was higher than PS (0.41±0.19 vs. 0.28±0.14, χ2=8.52, P=0.01). The adenoids-nasopharynx ratio was higher than that of PS group (0.70±0.07 vs. 0.62±0.10, χ2=8.96, P=0.01). The hypertrophy of tonsil was higher than PS group (2(1,2) vs. 1(1,2), χ2=7.95, P<0.05).
CONCLUSIONHypoxia and abnormal sleep structure are present in HS children with an OAHI of 1 to 5, and they also have the clinical features of OSAHS.
Adenoids ; pathology ; Adolescent ; Child ; Child, Preschool ; Humans ; Hypertrophy ; Hypoxia ; Oxygen ; blood ; Palatine Tonsil ; pathology ; Polysomnography ; Retrospective Studies ; Sleep ; Sleep Apnea, Obstructive ; diagnosis ; Snoring ; Surveys and Questionnaires