OBJECTIVE: To evaluate diagnostic significance of the noninvasive and objective 320-slice CT scan in the high pharynx resilience in the patients with obstructive sleep apnea/hypopnea syndrome. METHOD: Fifty patients with OSAHS and 10 patients with pharyngeal paraesthesia were included in the study. 320 slice CT scan was used to measure the sagittal diameters, transverse diameters and sectional area of the retropalatal region, retroglossal region. Calculating the pharynx wall resilience. Analyzing the correlativity of pharynx wall resilience, BMI and AHI. Fiber endoscope was used to assess the subsidence percentage of the pharynx wall. RESULT: Between OSAHS patients and pharyngeal paraesthesia patients, there was obviously difference in the retropalatal region and retroglossal region upper airway. The pharynx wall resiliences of retropalatal region were much more than that of retroglossal region. The later pharynx wall resiliences were much more than the fore-to-aft pharynx wall resiliences in the retropalatal region. BMI, AHI and the pharynx wall resilience were positive correlative to each other. But AHI and the pharynx wall resilience was nonlinear correlative. There was a good concordance between the pharynx wall resilience detected by 320CT and subsidence percentage of the pharynx wall detected by fiber endoscope. CONCLUSION 320 slice CT is a kind of simple, rapid and objective method to localize the high resilience area of upper respiratory tract, which can be benefit to the clinical diagnosis, the etiological study and the treatment of OSAHS. Based on physical examination, we propose that only one time of CT scan to the patients' upper airway at the Muller' stage is enough to localize the stenosis area, which can reduce radiation dosage dramatically.
Adolescent ; Adult ; Aged ; Female ; Humans ; Lung Compliance ; Male ; Middle Aged ; Sleep Apnea, Obstructive ; diagnosis ; diagnostic imaging ; physiopathology ; Tomography, X-Ray Computed ; Young Adult

Objective To explore the value of improved CT perfusion in delineation of brain arteriovenous malformation(AVM) target for stereotactic radiosurgery.Methods 22 patients diagnosed with AVM by DSA were included in this study.14 cases of AVM were detected from initial symptoms of intracereb.ral hemorrhage,of which 4 cases were given immediate intracranial hematoma evacuation,then in 3 cases postoperative embolization was performed,and other 10 cases received conservative treatment including 3 cases treated by embolization.8 cases of AVM were detected from initial symptoms of epilepsy or headache,without surgery or embolization treatment.In all patients,the improved CT perfusion and MRA examinations were performed before treatment to evaluate the diagnostic efficacy of different methods in AVM.Results The interference rates of hemorrhage and granulation tissue on MRA images were 27.3 ％ and 54.5 ％,respectively,while those on enhanced CT and improved CT perfusion images were 0 ％.The interference rate of embolization material on enhanced CT and improved CT perfusion images was 27.3％,while that on MRA images were 0％.The contrast-enhancement rates of MRA,CT and improved CT perfusion images were 4 5.5 ％,5 4.5 ％ and 7 2.7 ％,respectively.Conclusion Improved CT perfusion technique is helpful in delineation of brain AVM target for stereotactic radiosurgery in patients with AVM combined with intracerebral hemorrhage or postoperative patients.

OBJECTIVE: To discuss the method and effect of exercising larynx and genioglossus to treat obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: Fifty-four patients who were diagnosed as OSAHS and exercised larynx and genioglossus were defined as treatment group. We took Epworth sleep scale, check patient's PSG, and took computer tomography (320CT) before treatment, 6 months and 12 months later. We made a record of AHI, LSaO2, BMI, the shortest sagittal diameter and transverse diameter. Compared with 30 patients who had taken UPPP surgery (control group 1) and the 21 patients without any treatment (control group 2) at the same time. SPSS 10.0 was used to analyze the data. RESULT: According to Chinese OSAHS construction in 2009, 6 months and 12 months later, the effective rates of treatment group were 31.48% and 44.44%, among which the effective rates in mild and moderate patients of treatment group were 44.74% and 63.16%. Before treatment the mark of Epworth sleep scale was 7.67, 6 month and 12 month later the marks were 3.54 and 3.25. AHI were up to 15.45 after 6 months and 13. 60 after 12 months from 22. 84 at the beginning. LSaO2 were up to 81.18% after 6 months and 81.93% after 12 months from 74.05% at the beginning. The effective rate of control group 1 was 66.67%, and was much higher than the treatment group 6 months later (P < 0.05). But there was no statistics difference of effective rate between treatment group and control group 1 (36.67%) after 12 months (P > 0.05). The effective rates of treatment group were much higher than control group 2 (P < 0.01). After 12 months, the sagittal wall compliance of retropalatal area was lower (P < 0.01). There was no significant change of BMI in every group. CONCLUSION Exercising larynx and genioglossus is one kind of non-invasive and effective method without payment to treat part of OSAHS patients, especially the patients who is old, without surgical condition, and especially mild and moderate OSAHS patient that do not want to take surgery and CPAP treatment. Besides, exercising larynx and genioglossus can be considered as remedial treatment of OSAHS to surgery and other therapy.
Adult ; Aged ; Exercise Therapy ; Female ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; Pharynx ; Sleep Apnea, Obstructive ; therapy ; Young Adult