Evaluation of Pharyngeal Volume and Compliance of OSAHS Patients Using 3D CT and Volume Measurement
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Study objectives : The intrinsic properties such as baseline caliber and compliance of the upper airway are thought to be important in the pathogenesis of obstructive sleep apnea hypopnea syndrome (OSAHS). The author attempted using imaging methods to evaluate both baseline caliber and compliance in normal individuals and OSAHS patients, and to localize the obstructive sites in OSAHS patients. Design : Critical closing pressure (P_<crit>) and minimally effective therapeutical pressure (P_<eff>) were measured and computed tomography (CT) scan of pharynx was performed during wakefulness and drug-induced sleep with P_<crit>, Ocm_2O and P_<eff> being given through a nose mask system. Setting : Kanazawa medical University Hospital Subjects : 7 normal individuals (age, 32.2±6.5y's and body mass index, 23.6±5.4kg/m^2) and 13 OSAHS patients (age, 33.3±6.4y's and body mass index, 25.9±6.0kg/m^2) were studied. Interventions : 3D images of pharyngeal airway were reconstructed, and volume of each subdivision of pharynx was measured. Volume, average area and compliance of each subdivision were compared between the two groups. Results : On an air-mode view of 3D image, the outline of pharynx was shown as transparent tubal structure, on which the narrowing collapse of airway at any level or any direction can be easily identified. Anatomy of pharynx could be easily understood on the virtual endoscopic mode. During wakefulness, the average area of the upper (1.20±0.26cm^2 vs. 1.57±0.17 cm^2, P<0.05) and middle part of pharynx (1.89±0.52cm^2 vs. 2.58±0.27 cm^2, P<0.05) was significantly smaller in OSAHS patients than in normal individuals, respectively. During sleep, this difference was more obvious at the upper part (0.77±0.30 cm^2 vs. 1.45±0.18 cm^2, P<0.01) ; and middle part, (1.15±0.47 cm^2 vs. 2.44±0.26 cm^2). The compliance of the middle part (0.28±0.15/cmH_2O vs. 0.13±0.07 /cmH_2O, P<0.05) of pharynx was significantly higher in OSAHS patients than in normal individuals. Conclusion : The data suggested that OSAHS patients have a narrower and more collapsible pharynx compared to the normal subjects. The method of the present study is valid to evaluate both morphology and function of the upper airway.
- 金沢医科大学の論文
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関連論文
- THE VALUE OF PSEUDO-3-DIMENSIONAL CT IMAGES IN NAVIGATED ENDOSCOPIC SINUS SURGERY
- Evaluation of Pharyngeal Volume and Compliance of OSAHS Patients Using 3D CT and Volume Measurement