Magnetic resonance imaging of the upper airway structure of children with sleep disordered breathing / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the upper airway structure of sleep-disordered breathing children.</p><p><b>METHODS</b>Seventy three children with obstructive sleep apnea hypopnea syndrome (OSAHS), 53 children with primary snoring (PS) and 40 control subjects underwent pharyngeal magnetic resonance imaging (MRI). Upper airway structure images were analyzed and measured.</p><p><b>RESULTS</b>The cross-section area of the nasopharyngeal and palatopharyngeal airway in subjects with OSAHS and PS are smaller (P < 0.01) than that of the control group. The cross section area of OSAHS patients are smaller than that of PS subjects (P < 0.01). The above parameter of oropharyngeal airway in OSAHS patients is smaller than that of control group (P < 0.01), but no statistic difference compared with that of PS subjects. The cross-section area and length of the adenoid in OSAHS group are bigger and longer than that of PS group (P < 0.01) and bilateral tonsils are larger (P < 0.01); in OSAHS patients the cross-section area of the soft palate is larger and the length of the soft palate is longer (P < 0.01) than that of PS group, while this parameter of PS group is similar to that of the control group. And the maximum width of the soft palate, the cross-section area of bilateral fat pad, bilateral pterygoid and tongue are similar among OSAHS, PS and the control group. The skeletal measurement: the length of H-C2C3 in subjects with OSAHS is longer (P < 0.01); The angle(alpha) in OSAHS patients is smaller (P < 0.01) than that of other 2 groups. The angle (beta), the cross-section area of the mandible, the spine-clivus oblique, the length of the hard palate and the distance of the mandible are similar among the three groups.</p><p><b>CONCLUSIONS</b>In children with OSAHS or PS, the upper airway is restricted by both the adenoid and tonsils; however, the soft palate is also larger in OSAHS, adding further restriction. Otherwise, downward movement of the hyoid bone and decreasing of the angle (alpha) in OSAHS influence laryngopharynx airway. MRI is of clinical significance for evaluating OSAHS children's upper airway.</p>

Cross-check of caloric test and head shaking nystagmus / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the manifestation of head shaking nystagmus (HSN) and the relationship between HSN and vestibular bithermal test while cross-checking the HSN and vestibular bithermal test.</p><p><b>METHODS</b>One hundred and twenty-four patients were examined by HSN and vestibular bithermal test. The latency and duration of HSN were observed and the dynamic changes of HSN were also investigated. The results of bithermal test were clarified by the values of canal paresis (CP).</p><p><b>RESULTS</b>There were 3 types of HSN, including 41 monophasic HSN, 11 biphasic HSN and 7 perverted HSN. The latency of monophasic HSN was (2.75 +/- 1.41) ms and the duration of it was (32.16 +/- 20.30) ms; as for the biphasic HSN, the first phase had no latency and the duration was (12.33 +/- 4.42) ms which was shorter than that of the second phase (57.00 +/- 17.19) ms (P < 0.01) and the latency of second phase was (57.00 +/- 17.19) ms. The value of canal paresis in the patients without HSN was lower than that in the patients with HSN.</p><p><b>CONCLUSIONS</b>The existence of HSN was dependent on the loss of the function horizontal canal and also on the stage of vestibular compensation. The variation of duration of HSN among individuals was great. In the acute stage of unilateral vestibular function loss, there appeared to be prominent HSN, and the direction of HSN is the same as that of spontaneous nystagmus. With the development of vestibular compensation, biphasic nystagmus would appear instead of monophasic HSN and the direction of first phase represent the direction of un-lesioned side. After compensation, HSN would not be elicited. However,when HSN existed, it suggested that the value of CP should exceed 25%. Perverted nystagmus pointed to central abnormality.</p>