Magnetic resonance imaging of the upper airway in obstructive sleep apnea before and after oral appliance therapy.
Magnetic resonance imaging of the upper airway in obstructive sleep apnea before and after oral appliance therapy.
复制标题
口腔矫治器治疗前后阻塞性睡眠呼吸暂停上呼吸道的磁共振成像。
DOI：
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发表时间：
1999
期刊：
影响因子：
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通讯作者：
X. Huang
中科院分区：
文献类型：
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作者：
X. Gao;X. Zeng;M. Fu;X. Huang
目的
确定口腔矫治器治疗阻塞性睡眠呼吸暂停综合征（OSAS）的机制。
方法
11名OSAS患者（8名男性和3名女性）参与了这项研究。平均年龄为52.2 ± 10.6岁;身高为166.6 ± 7.2 cm，体重为75.6 ± 9.3 kg;体重指数（BMI）为27.2 ± 2.9 kg/m2。每例患者在口腔矫治器治疗前后均进行磁共振成像（MRI）和多导睡眠图检查。测量咽部的变化，并与睡眠参数的变化进行比较。同时，应用Pearson相关分析和多元线性回归分析研究睡眠参数与MRI检查项目的关系。
结果
通过口腔矫治器治疗，睡眠障碍减少。呼吸暂停/呼吸不足指数（AHI）从每小时睡眠44.6 +/- 21.5降至9.6 +/- 6.3。最低氧饱和度从71.4 +/- 15.0%上升至82.0 +/-7.7%。同时，上呼吸道在大部分水平均增加，尤其是口咽部。经相关和回归分析，AHI变化与舌量呈负相关（R = -0.5730），与高口咽面积变化呈正相关（R = 0.5823），最低血氧饱和度（SaO2%）变化与全气道容积呈正相关（R = 0.6554）。
结论
口腔矫治器通过扩大上气道形态，保持气道开放，主要作用于软腭后部。口腔矫治器的效果与高位口咽的扩大程度有关。对于那些舌头小而咽部大的人来说，使用口腔矫治器可能会有很好的效果。
OBJECTIVE
To determine the mechanism by which an oral appliance may be used to treat obstructive sleep apnea syndrome (OSAS).
METHODS
Eleven OSAS patients (8 males and 3 females) were involved in the study. Mean age was 52.2 +/- 10.6 years; height was 166.6 +/- 7.2 cm, and weight was 75.6 +/- 9.3 kg; body mass index (BMI) was 27.2 +/- 2.9 kg/m2. Each patient underwent magnetic resonance imaging (MRI) and polysomnography before and after oral appliance therapy. Pharyngeal changes were measured and compared with the variation in sleep parameters. Also, Pearson's correlation and multiple linear regression were performed to investigate the relationship of sleep parameters and MRI items.
RESULTS
Through oral appliance therapy, the sleep disorder decreased. Apnea/hypopnea index (AHI) decreased from 44.6 +/- 21.5 to 9.6 +/- 6.3 per hour of sleep. Lowest oxygen desaturation rose from 71.4 +/- 15.0% to 82.0 +/- 7.7%. Meanwhile, the upper airway increased at most levels, and especially at oropharynx. As measured by the correlation and regression analysis, the AHI changes had a negative association with tongue volume (R = -0.5730) and a positive association with the area alternation of high oropharynx (R = 0.5823); the change of the lowest oxygen desaturation (SaO2%) was positively associated with whole airway volume (R = 0.6554).
CONCLUSION
The oral appliance works by enlarging the upper airway morphology and keeping the airway open, mainly at the back of soft palate. The effect of the oral appliance is associated with the degree of enlargement of the high oropharynx. Those who have a small tongue and a large pharynx may expect to have good results with the use of the oral appliance.