Diagnosis and Therapy: Obstructive Sleep Respiratory Disorders.

概要

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Obstructive sleep respiratory disorder (OSRD) is a breathing disorder which occurs during sleep, which includes snoring and the obstructive sleep apnea syndrome.Sixty-three adult patients who had been diagnosed as having OSRD underwent polysomnographic diagnosis with multiple barosensors to find the site of obstruction. There were four types of OSRD: the soft-palate type, root-of-tongue type, combined type and transfer type. The soft-palate type was shown by 39.7% of cases, the root-of-tongue type 27.0%, the combined type 30.2% and the transfer type 3.2%. The effectiveness of UPPP (uvulopalatopharyngoplasty) had been 50-80%, similar to our data for the soft-palate type. The patients for whom UPPP was not effective perhaps had an obstruction in an area other than the soft palate. Twelve patients whose site of obstruction was at the root of the tongue underwent mid-line glossectomy. Preoperative and postoperative results of polysomnography showed that the absolute mean value of the intraesophageal pressure decreased from 52.5cmH2O to 27.1cmH2O, and that the mean value of AHI (apnea hypopnea index) decreased from 56.0 to 29.4.The correct diagnosis of the obstructed area and the selection of the operative method most appropriate for the area are very important. Mid-line glossectomy is the most effective treatment for the root-of-tongue type of obstruction.
特定非営利活動法人日本気管食道科学会の論文