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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Upper airway and its surrounding structures in obese and nonobese patients with sleep-disordered breathing.
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Upper airway and its surrounding structures in obese and nonobese patients with sleep-disordered breathing.

机译：患有睡眠呼吸障碍的肥胖和非肥胖患者的上呼吸道及其周围结构。

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OBJECTIVES/HYPOTHESIS: The objective was to understand the pathophysiological relationship between obesity and sleep-disordered breathing by using cephalometry with the Muller maneuver. STUDY DESIGN: A prospective study. METHODS: One hundred habitually snoring men were evaluated for sleep-disordered breathing at the Sleep Center of Chang Gung Memorial Hospital (Taipei, Taiwan). Each subject received overnight polysomnography and two lateral cephalograms at the end-expiration phase (L1) and the Muller maneuver (L2), respectively, to evaluate the facial skeleton and the upper airway and its surrounding structures (soft palate, tongue, epiglottis, and hyoid bone). After excluding 14 patients from the study because of jaw opening during cephalometry, 86 (39 nonobese and 47 obese) patients with sleep-disordered breathing were enrolled. RESULTS: Patients with varying degrees of obesity significantly differed in terms of the facial skeleton and the structure and function of the upper airway and its surrounding structures. The Muller maneuver caused dynamic changes in the hypopharyngeal airway and position of the tongue, and these dynamic changes were related to the pathogenesis of sleep-disordered breathing for the two groups (nonobese and obese patients). The regression model generated for the nonobese group revealed that the apnea hypopnea index was significantly related to the pharyngeal length (L2) and the soft palate thickness (L1). In contrast, the regression model generated for the obese group revealed that the apnea hypopnea index was significantly related to the soft palate (length [L1] and dynamic position change), the hyoid position (vertical [L1] and horizontal [L2]), the tongue (dynamic position change), and body mass index. CONCLUSION: Cephalometry with the Muller maneuver may provide further insight into the pathogenesis of sleep-disordered breathing for the two groups of patients (nonobese and obese patients).
机译：目的/假设：目的是通过Muller动作进行头颅测量来了解肥胖与睡眠呼吸障碍之间的病理生理关系。研究设计：一项前瞻性研究。方法：在台湾台北长庚纪念医院睡眠中心对一百名习惯性打呼men的人进行睡眠呼吸评估。每个受试者在呼气末期（L1）和Muller动作（L2）分别接受通宵多导睡眠图检查和两个侧位脑波图，以评估面部骨骼和上呼吸道及其周围结构（软pa，舌头，会厌和舌骨）。在因头颅测量期间下颌张开而将14名患者排除在研究之外之后，纳入了86名（睡眠异常，肥胖和47名）睡眠呼吸障碍的患者。结果：肥胖程度不同的患者在面部骨骼以及上呼吸道及其周围结构的结构和功能方面存在显着差异。 Muller动作导致下咽气道和舌头位置发生动态变化，这些动态变化与两组（非肥胖和肥胖患者）睡眠呼吸障碍的发病机制有关。为非肥胖组生成的回归模型显示，呼吸暂停低通气指数与咽长度（L2）和软pa厚度（L1）显着相关。相反，针对肥胖组生成的回归模型显示，呼吸暂停低通气指数与软pa（长度[L1]和动态位置变化），舌骨位置（垂直[L1]和水平[L2]）显着相关，舌头（动态位置变化）和体重指数。结论：采用Muller动作的头颅测量法可以为两组患者（非肥胖和肥胖患者）睡眠呼吸障碍的发病机理提供进一步的认识。

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