The role of the nose in snoring and obstructive sleep apnoea: an update.
The role of the nose in snoring and obstructive sleep apnoea: an update.
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DOI：
10.1007/s00405-010-1469-7
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发表时间：
2011-09
期刊：
影响因子：
--
通讯作者：
Georgalas C
中科院分区：
文献类型：
--
作者：
Georgalas C
打鼾和阻塞性睡眠呼吸暂停 (OSA) 中经常出现多级解剖阻塞。由于鼻子是上呼吸道的第一个解剖边界，鼻塞可能会导致睡眠呼吸障碍 (SDB)。许多病理生理学机制可以解释鼻腔病理学在 SDB 中的作用。其中包括 Starling 电阻模型、不稳定的口腔气道、鼻通气反射和一氧化氮 (NO) 的作用。临床上，许多病例对照研究表明鼻塞与打鼾和轻度SDB有关。然而，鼻塞程度与SDB严重程度之间并不存在线性相关性，而鼻塞并不是大多数中重度OSA患者的主要影响因素。随机对照研究表明，对于患有过敏性鼻炎或非过敏性鼻炎并伴有睡眠障碍的患者，鼻用类固醇可以改善主观睡眠质量，并且可能对轻度 OSA 患者有用，但它们本身不足以治疗大多数 OSA 患者。同样，鼻部手术可能会改善轻度 SDB 和鼻中隔偏曲患者的生活质量和打鼾情况，但它并不是治疗 OSA 的有效方法。另一方面，对于不能很好地耐受持续气道正压通气 (CPAP) 的患者，如果上气道评估显示鼻道阻塞，鼻气道手术可以提高 CPAP 的依从性和依从性。
Multilevel anatomic obstruction is often present in snoring and obstructive sleep apnoea (OSA). As the nose is the first anatomical boundary of the upper airway, nasal obstruction may contribute to sleep-disordered breathing (SDB). A number of pathophysiological mechanisms can potentially explain the role of nasal pathology in SDB. These include the Starling resistor model, the unstable oral airway, the nasal ventilatory reflex and the role of nitric oxide (NO). Clinically, a number of case–control studies have shown that nasal obstruction is associated with snoring and mild SDB. However, there is not a linear correlation between the degree of nasal obstruction and the severity of SDB, while nasal obstruction is not the main contributing factor in the majority of patients with moderate to severe OSA. Randomised controlled studies have shown that in patients with allergic rhinitis or non-allergic rhinitis and sleep disturbance, nasal steroids could improve the subjective quality of sleep, and may be useful for patients with mild OSA, however, they are not by themselves an adequate treatment for most OSA patients. Similarly, nasal surgery may improve quality of life and snoring in a subgroup of patients with mild SDB and septal deviation, but it is not an effective treatment for OSA as such. On the other hand, in patients who do not tolerate continuous positive airway pressure (CPAP) well, if upper airway evaluation demonstrates an obstructive nasal passage, nasal airway surgery can improve CPAP compliance and adherence.
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影响因子：
3.4
作者：
Friedman, M;Tanyeri, H;Caldarelli, D
通讯作者：
Caldarelli, D
DOI：
10.2500/105065801781543745
发表时间：
2001-03-01
期刊：
AMERICAN JOURNAL OF RHINOLOGY
影响因子：
--
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
1.4
作者：
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通讯作者：
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影响因子：
5.9
作者：
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通讯作者：
Ekici, Mehmet