Upper airway shape. Is it important in the pathogenesis of obstructive sleep apnea?
Upper airway shape. Is it important in the pathogenesis of obstructive sleep apnea?
复制标题
DOI：
10.1164/ajrccm.153.3.8630569
复制
发表时间：
1996-03-01
影响因子：
24.7
通讯作者：
Leiter, JC
中科院分区：
文献类型：
--
作者：
Leiter, JC
人们普遍认为，气道的大小和上气道肌肉活动的水平有助于阻塞性睡眠呼吸暂停（OSA）的发病机制。然而，一些气道大小正常且上气道肌肉活动明显正常的个体仍然会患上 OSA。最近的数据和分析表明，气道形状也可能有助于 OSA 的发生； OSA 患者往往有椭圆形气道，椭圆的长轴沿前后轴方向，这种方向可能会对上气道肌肉功能产生不利影响。通过将气道形状、气道大小和上气道肌肉活动纳入 OSA 发病机制的统一假说，有可能调和 OSA 患者不同的解剖学和肌电图结果，解释使用现有诊断工具为 OSA 患者选择适当手术治疗的困难，并了解这些患者对上气道手术的反应常常令人失望。
It is widely accepted that the size of the airway and the level of upper airway muscle activity contribute to the pathogenesis of obstructive sleep apnea (OSA). However, some individuals with normal airway size and apparently normal upper airway muscle activity nonetheless develop OSA. Recent data and analysis suggest that airway shape may also contribute to the development of OSA; patients with OSA tend to have elliptical airways, with the long axis of the ellipse oriented along the anteroposterior axis, and this orientation may adversely affect upper airway muscle function. By incorporating airway shape, airway size, and upper airway muscle activity into a unified hypothesis of the pathogenesis of OSA, it may be possible to reconcile discrepant anatomic and electromyographic findings in patients with OSA, to explain the difficulty of selecting appropriate surgical therapy for patients with OSA using currently available diagnostic tools, and to understand the often disappointing response to upper airway surgery in these patients.