The male predisposition to pharyngeal collapse - Importance of airway length
The male predisposition to pharyngeal collapse - Importance of airway length
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DOI：
10.1164/rccm.2112072
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发表时间：
2002-11-15
影响因子：
24.7
通讯作者：
White, DP
中科院分区：
文献类型：
--
作者：
Malhotra, A;Huang, YQ;White, DP
阻塞性睡眠呼吸暂停是一种重要的疾病，因为它的患病率及其心血管和神经认知后遗症。尽管事实上男性是这种疾病的主要危险因素，但这种易感性的机制尚不清楚。为了了解男性咽部塌陷易感性的病理生理基础，我们对一组正常和接近正常受试者（男性和女性人数相等）的上呼吸道的解剖和生理特征进行了详细分析。虽然没有重要的生理（颏舌肌肌电图，气流阻力）性别之间的差异，观察到一些解剖差异是明显的。男性的咽气道长度明显长于女性。与女性相比，男性的软腭横截面积和气道容积也有所增加。使用男性和女性受试者的信号平均解剖数据，我们开发了代表性的男性和女性有限元气道模型。该模型证明男性气道比女性气道更容易塌陷，这仅仅是基于解剖学差异。这项研究表明，男性易患咽部塌陷是解剖学基础上，主要是由于增加长度的脆弱的气道，以及增加软腭的大小。
Obstructive sleep apnea is an important disorder because of both its prevalence and its cardiovascular and neurocognitive sequelae. Despite the fact that male sex is a major risk factor for this disorder, the mechanisms underlying this predisposition are unclear. To understand the pathophysiologic basis of the male predisposition for pharyngeal collapse, we performed a detailed analysis of the anatomic and physiologic features of the upper airway in a cohort of normal and near-normal subjects (equal number of men and women). Although no important physiologic (genioglossal electromyogram, airflow resistance) differences were observed between sexes, a number of anatomic differences were apparent. The pharyngeal airway length was substantially longer in men compared with women. There was also an increased cross-sectional area of the soft palate and an increased airway volume in men compared with women. Using signal-averaged anatomic data from male and female subjects, we developed representative male and female finite element airway models. This model demonstrated the male airway to be substantially more collapsible than the female airway, solely on the basis of anatomic differences. This study suggests that the male predisposition to pharyngeal collapse is anatomically based, primarily as the result of an increased length of vulnerable airway as well as increased soft palate size.