Effective three-dimensional evaluation analysis of upper airway form during oral appliance therapy in patients with obstructive sleep apnoea
Effective three-dimensional evaluation analysis of upper airway form during oral appliance therapy in patients with obstructive sleep apnoea
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DOI：
10.1111/joor.12059
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发表时间：
2013-08-01
影响因子：
2.9
通讯作者：
Kazaoka, Y.
中科院分区：
文献类型：
--
作者：
Furuhashi, A.;Yamada, S.;Kazaoka, Y.
口腔矫治器被认为是治疗阻塞性睡眠呼吸暂停(OSA)的有效方法。在骨性关节炎治疗过程中，上呼吸道的扩张是至关重要的，侧位头影测量已被用于在该治疗过程中对上呼吸道形态的二维评估。然而，这种方法不能提供准确的上呼吸道形态的三维(3D)视图。为了证实OA对OSAS患者上呼吸道的影响，我们对15例接受OA治疗的日本患者(男12例，女3例)进行了有无OA的CT检查。对每例患者连续行有无骨性关节炎的CT扫描，测量与腭面平行的6个任意平面上的上呼吸道横截面积。然后进行三维图像重建，评价上呼吸道形态的变化，并测量从腭平面到会厌最深处三个水平的上呼吸道容量。与无OA组相比，OA组后软腭区两平面的横截面积明显增大。在OA存在的情况下，软腭后区的上呼吸道横截面积和容量较舌后区显著增大。三维CT图像重建准确地证实了OA治疗过程中上呼吸道的形态变化。这种3D评估的持续使用有望在未来改善OA治疗的结果。
The oral appliance (OA) is considered to be an effective treatment modality for obstructive sleep apnoea (OSA). Upper airway enlargement during OA therapy is critical, and lateral cephalometry has been used for the two-dimensional evaluation of upper airway form during this therapy. However, this method cannot provide an accurate three-dimensional (3D) view of upper airway form. To confirm the effects of OA on the upper airway in patients with OSAS, we performed CT in the presence and absence of OA in 15 Japanese patients (12 males, 3 females) who responded to OA therapy. CT in the presence and absence of OA was consecutively performed for each patient, and upper airway cross-sectional area in six arbitrary planes parallel to the palatal plane was measured. Next, 3D image reconstruction was performed; morphological changes in upper airway form were evaluated, and upper airway volume at three levels from the palatal plane to the deepest point of the epiglottis was measured. The cross-sectional area of two planes in the posterior soft palate region significantly increased in the presence of OA compared with that in the absence of OA. In the presence of OA, upper airway cross-sectional area and volume significantly increased in the posterior soft palate region compared with those in the posterior tongue region. 3D CT image reconstruction accurately confirmed morphological changes in the upper airway during OA therapy. Continued use of this 3D evaluation is expected to improve the results of OA therapy in the future.