Changes in nasal resistance and air way structure associated with orthognathic surgery.

本研究旨在探讨正颌外科手术对呼吸生理及形态学的影响（Obwegeser Dalpon't法）对鼻阻力和上咽气道结构的影响：实验一，观察13例经鼻气管插管患者术后鼻阻力的变化，拔管后每天用面罩前法测量鼻阻力。实验2，资料由10例患者术前、术后头颅侧位片组成，统计结果和主观评价表明：结论：1.在插管侧，由于气管导管的机械压力，拔管后鼻阻力立即降低，第二天增加。术后第2天恢复到术前水平，无明显变化.未插管侧鼻阻力在拔管后即刻升高，次日下降.围手术期总阻力和纤维镜检查结果无明显变化.盐酸曲马唑啉鼻腔给药后阻塞侧鼻阻力明显降低.术后咽气道宽度较术前稍有减少，但远小于术后颏部回缩量.拔管后咽部气道面积稍有缩小，但不代表气道阻塞，提示术后气道安全，应注意术后2天气道管理。

The purpose of this study was to investigate the respiratory physiological and morphological effects of orthognathic surgery (Obwegeser Dalpon't method) on nasal resistance and upper pharyngeal air way structure.On experiment 1, the change of nasal resistance in postoperative period was investigated in thirteen patients who underwent nasal endtracheal intubation, and the nasal resistance was measured by the mask anterior method for every day after extubation.On experiment 2, materials were composed of pre and postoperative lateral cephalogram of ten individuals.The statistical results and subjective appraisal suggest the following conclusions :1. On the intubated side, the nasal resistance was decreased immediately after extubation due to mechanical pressure of the endotracheal tube, and increased on the next day. After 2nd post operative day, it returned to the preoperative value, and it did not change any more.2. On the not intubated side, the nasal resistance increased just after extubation, and decreased on next day.3. There was no significant change in total resistance and fiber scopic finding for the perioperative period.4. The nasal resistance of obstructed side was severly decreased after intra-nasal administration of tramazoline HCI.5. The width of pharyngeal air way was slightly decreased anteroposteriorly but this was much smaller than the amount of chin retraction associated with operation.6. The area of pharyngeal air way was slightly decreased but this was not indicate air way obstruction immediately after extubation.The findings in the present studies indicate the safty of air way in post-operative period and suggested the attention should be paid to the management of air way for two days after operation.