<シンポジウム>1 睡眠時無呼吸の病態を考慮した耳鼻科的治療(睡眠時無呼吸症候群)

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Uvulopalatopharyngplasty (UPPP) has been generally applied in the treatment of obstructive sleep apnea (OSA). Larsson et al carried out a long-term follow-up study after UPPP. Six months after surgery, 60% of the patients were classified as good responders. However 21 months after surgery, the ratio of good responders to UPPP decreased to 36%. They reported that the patients who relapsed showed a significant increase in mean body mass index between the first and second postoperative recordings as compared with patients who remained responders. Miyazaki et al examined the influence of obesity and sleep position in 68 OSA cases by polysomnography including upper airway pressure monitoring. The subjects were divided into three group according to theie obesity : normal weight group, obesity index less than 110%; mildly obese group, between 110%-120%; and obese group, more than 120%. The apnea + hypopnea index (AHI) in theobese group was 47.1/h in the supine position, which was significantly higher than those in the normal weight group (32.6/h) and mildly obese group (31.3/h). In the lateral sleeping position, the values of AHI, lowest oxygen saturation and intraesophageal pressure change were more severe in the obese group than those in the normal weight and mildly obese groups. Miyazaki et al also reported that sleep apnea patients with medium to large tonsils and a normal soft palate can be treated effectively (80% AHI reduction) with tonsillectomy. Obesity may worsen the respiratory disorder, there by decreasing the effectiveness of tonsillectomy.
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<シンポジウム>1 睡眠時無呼吸の病態を考慮した耳鼻科的治療(睡眠時無呼吸症候群)

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