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Upper airway soft tissue abnormalities in patients with obstructive sleep apnea

TONG Mao rong, YUE Wei, XIA Xi rong (Department of Respiratory Diseases, Jinling Hospital , Nanjing 210002,China)  
Objectives: To explore the upper airway soft tissue abnormalities and their possible contributions to the apneic severity in patients with obstructive sleep apnea (OSA). Methods: One night polysomnographic examination and a lateral cephalogram were performed in 102 male OSA patients and 37 healthy men. Twelve variables representing the length and area of the upper airway soft tissues were measured by a computer software (NIH Image). Results: OSA patients had: ① an elongated and larger soft palate,② a greater total tongue volume, especially an increased inferior tongue mass,③ an elongated contact line between the soft palate and the tongue, ④an elongated pharyngeal airway and thicker airway wall, possibly due to increased fatty tissue deposit. Multiple stepwise regression analysis disclosed that the length of the pharyngeal wall (or the area of the inferior tongue) was the second most important contributing factors to the apneic severity next to body mass index. Conclusions: OSA patients had significant upper airway soft tissue abnormalities and cephalometric analysis of these abnormalities is useful both in the investigation of the pathogenesis and the selection of an individualized treatment modality for each OSA patients.
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