Study for the etiological diagnosis of obstructive sleep apnea and survey in oral and maxillofacial diseases.

阻塞性睡眠呼吸暂停的病因诊断及口腔颌面部疾病调查研究。

• 批准号: 05671664
• 负责人: KOHNO Masaki
• 金额: $ 1.34万
• 依托单位: Niigata University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1993
• 资助国家: 日本
• 起止时间: 1993 至 1994
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-05671664/
• 关键词: Oral and maxillofacial disease; Sleep apnea syndrome; Sleep oximetry; Contrasted lateral cephalogram; Excess of soft palate; Distance between palatal plane and hyoid bone; Mean pharyngeal airway space; Airway Analyzing Chart; 口腔外科手術; 睡眠オキシメトリー法 /

In spite of variant anatomic deformities claimed as etiologic factors for OSA,the morphologic analysis of this condition has not been well established. In this study, a new method of diagnosing the etiology and the severity of OSA was studied.To diagnose any patients as OSA,the Sleep Oximetry which was a method applicable even to uncooperative child for diagnosis of OSA instead of polysomnography was developed. A parameter, %TSpO_2<90 which was the percentage of the time spent below 90% of SpO2 was related to the apnea/hypopnea index (AHI) closely and seemed to be useful for physiological diagnosis of OSA.On the other hand, a study was designed to establish a new method of diagnosing the etiology of OSA using contrasted lateral cephalograms. The subjects of the study consisted of 13 patients who had undergone surgical treatment of OSA.Twenty six pairs of cephalograms and polysomnograms taken pre/postoperatively were used for the analysis. As result, two Airway Analyzing Charts (AAC) were obtained from the multivariate analysis. One regression equation was (AHI)=1.48(EX)-2.63(mPAS)+32.6 with an R^2 value of 0.70, where mPAS is the average width of the posterior airway space in mm and EX is the length of the soft palate in excess of the pharyngeal depth in mm. The other was (AHI)=1.62(EX)+0.98(PPH)-74.9 with an R^2 value of 0.71, where PPH is the distance from the palatal plane to the hyoid bone in mm.The incidence of OSA in the oral and maxillofacial diseases was investigated with Sleep Oximetry and AACs and then many OSAs were found in the various conditions such as retromandible (microgenia, agnathia, RA), Pierre-Robin syndrome, Crouzon syndrome, postpalatoplasty and maxillomandibular fixation. In conclusion, it seems that many oral and maxillofacial surgeons merely have not become aware of OSAs which have been occurring even in the common diseases of oral and maxillofacial region.

尽管各种解剖畸形被认为是阻塞性睡眠呼吸暂停综合征的病因，但这种情况的形态分析还没有得到很好的证实。本研究探讨了一种新的诊断阻塞性睡眠呼吸暂停综合征的病因和严重程度的方法，并开发了一种即使是不合作的儿童也可以代替多导睡眠图诊断阻塞性睡眠呼吸暂停综合征的方法。睡眠呼吸暂停低通气指数(AHI)与睡眠呼吸暂停低通气指数(AHI)密切相关，可用于阻塞性睡眠呼吸暂停低通气综合征(OSA)的生理学诊断。另一方面，本研究旨在建立一种利用对比头颅侧位片诊断OSA病因的新方法。研究对象为13例手术治疗的阻塞性睡眠呼吸暂停综合征患者，采用26对术前、术后头颅侧位片和多导睡眠图进行分析。通过多因素分析得到两张呼吸道分析图(AAC)。回归方程为(AHI)=1.48(Ex)-2.63(MPas)+32.6，R^2=0.70，其中mPas为平均后气道宽度(Mm)，ex为软腭长度超过咽部深度(Mm)。(AHI)=1.62(Ex)+0.98(PPH)-74.9，R^2=0.71，其中PPH为腭面到舌骨的距离，单位为mm。用睡眠氧饱和度和AACs调查口腔颌面部疾病OSA的发生率，发现OSA多见于颌后畸形、Pierre-Robin综合征、Crouzon综合征、腭裂术后和颌骨固定等。综上所述，许多口腔颌面外科医生似乎只是没有意识到OSAS已经发生在口腔颌面部的常见疾病中。