Resection of macrosis benign parapharyngeal neoplasms via oral approach / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore investigate the feasibility of transoral removal of macrosis benign neoplasms in parapharyngeal space.</p><p><b>METHODS</b>Sixteen patients with well-defined macrosis benign parapharyngeal space tumors treated by surgery from January 2005 to December 2012 were enrolled in this study. All patients were assessed by CT scan, MRI and CT angiography before surgery. Surgery for the tumors with complete peplos, locating at medial side of carotid and accessible from the oropharynx was completed with the assistance of endoscope, bipolar electrocoagulation or radiofrequency ablation system.</p><p><b>RESULTS</b>All neoplasms were removed by transoral approach. Tracheotomy was performed in 4 cases. All patients were treated successfully with good postoperative recovery and no significant complications. Postoperative pathological examination showed there were 9 cases of pleomorphic adenoma, 5 cases of neurilemmoma and 2 cases of neurofibroma. By the follows-up of 1-8 years (median 31 months), among 16 cases only one case of neurofibroma recurred.</p><p><b>CONCLUSION</b>The transoral removal of macrosis benign neoplasms in parapharyngeal space is safe, manimally invasive and feasible in selected cases, with a high local control rate and a low surgical complication rate.</p>

Difference of upper airway variety with respiration in the sufferer of OSAHS and normal adult / 临床耳鼻咽喉头颈外科杂志

Objective:To inquiry the variety difference of upper airway caliber OSAHS sufferer and normal person in quiet respiration Method:Twenty OSAHS sufferer who were viewed by PSG and 16 normal adults who hadve no chief complaint of sleeping disease were selected.The curves of the subjects in a respiratory cycle were recorded by respiratory monitoring system in PSG,while the morphological changes in the harynx of all subjects were observed by fiberscope in a calm respiratory cycle,and then both of the two processes simultaneously were recorded on the same computer.According to the different stages of respiratory cycle by analyzing respiratory curve the video had been edited into pictures about the various anatomical areas in the upper airway,he cross section area and the dimension of palate and lingua and root of the tongue region upper irway wereas studied by the image tools in computer,and the changes of areas and dimensions at palate,and lingua and root of the tongue region upper airway were calculated.Result:It was found that there wasis a morphological change f the upper airway with the respiratory movement in the both groups.The upper airway caliber decrease with inspiration begin and reach the most narrowing at the end of inspiration,then upper airway caliber enlarges with the expiration begin and reach the most widening at the end of expiration.No matter the normal group or the OSAHS roup has the obvious changes in the palate and lingua region on the diameter,the cross section area and the dimension in respiration.The changes in the palate and lingua region on the diameter,the cross section area and the dimension of OSAHS group were greater than normal group.No matter OSAHS group or normal group on the diameter nd cross section area change in the palate was obviously more than the tongue area and the root of tongue area.The changes of OSAHS group on the dimension in the palate were greater than the tongue area and the root of tongue area.Conclusion:There are periodically changes of upper airway during respiration cycle in normal adults and SAHS patients.The effects of respiration on upper airway caliber of OSAHS patients are more obviously than normal adults.and the increasing effects in OSAHS patients is one of OSAHS etiology.

Difference of upper airway variety with respiration in the sufferer of OSAHS and normal adult / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To inquiry the variety difference of upper airway caliber OSAHS sufferer and normal person in quiet respiration.@*METHOD@#Twenty OSAHS sufferer who were viewed by PSG and 16 normal adults who hagve no chief complaint of sleeping disease were selected. The curves of the subjects in a respiratory cycle were recorded by respiratory monitoring system in PSG, while the morphological changes in the pharynx of all subjects were observed by fiberscope in a calm respiratory cycle, and then both of the two processes simultaneously were recorded on the same computer. According to the different stages of respiratory cycle by analyzing respiratory curve the video had been edited into pictures about the various anatomical areas in the upper airway, the cross section area and the dimension of palate and lingua and root of the tongue region upper airway whereas studied by the image tools in computer, and the changes of areas and dimensions at palate, and lingua and root of the tongue region upper airway were calculated.@*RESULT@#It was found that there wasps a morphological change of the upper airway with the respiratory movement in the both groups. The upper airway caliber decrease with inspiration begin and reach the most narrowing at the end of inspiration, then upper airway caliber enlarges with the expiration begin and reach the most widening at the end of expiration. No matter the normal group or the OSAHS group has the obvious changes in the palate and lingua region on the diameter, the cross section area and the dimension in respiration. The changes in the palate and lingua region on the diameter, the cross section area and the dimension of OSAHS group were greater than normal group. No matter OSAHS group or normal group on the diameter and cross section area change in the palate was obviously more than the tongue area and the root of tongue area. The changes of OSAHS group on the dimension in the palate were greater than the tongue area and the root of tongue area.@*CONCLUSION@#There are periodically changes of upper airway during respiration cycle in normal adults and OSAHS patients. The effects of respiration on upper airway caliber of OSAHS patients are more obviously than normal adults, and the increasing effects in OSAHS patients is one of OSAHS etiology.

The effects of pressure level in veil on upper airway in patients with obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the effects of pressure level in veil on upper airway in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and normal adults.@*METHOD@#We scanned the upper airway from roof of nasopharynx to glottis with SIMENS 16 layer spiral CT scanner. The area and the dimensions of palate, uvula, and the region after lingua and epiglottis were measured by application of image work station. Forty-six patients with OSAHS and 35 normal adults were scanned by CT at 0 kPa water column and 0.784 kPa water column pressures in face mask, respectively.@*RESULT@#The area and inner diameter of OSAHS patients upper airways were less than those of normal adults at the same pressure in face mask. The area and inner diameter of upper airway at the pressure of 0.784 kPa water column were more than those at 0 kPa water column in both OSAHS patients and normal adults, and the increased extent of normal adults were more than those of OSAHS patients. We measured the minimum increased normal Cross sectional area of palate, uvula, and the region after lingua and epiglottis when the pressure in the mask increased from 0 kPa to 0.784 kPa, and we made it as the standard. The 46 OSAHS patients were sorted into 17 cases (group 1) with normal dilation and 29 cases (group 2) with less dilation in such standard. There was not significant difference between the two groups at 0 kPa pressures in area and inner diameter, but the area and inner diameter of group 1 were more than those of group 2 at 0.784 kPa pressure.@*CONCLUSION@#The increased pressure in face mask would lead to upper airway dilation both in OSAHS patients and normal adults, and the dilated extents of normal adults were significant more than those of OSAHS patients. The less dilation of OSAHS may be duo to anatomic constriction and some pharynx wall pathological changes.

The clinical investigation of the relationship between obstructive sleep apnea-hypopnea syndrome and insulin resistance / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and insulin resistance (IR), then evaluate the effectiveness of the improved Uvulopalatopharyngoplasty (MUPPP) and continuous positive airway pressure (CPAP) on IR.@*METHOD@#Fourteen patients of OSAHS were treated by MUPPP, and sixteen patients of OSAHS were treated by CPAP. All index of the nocturnal polysomnography, fasting plasma insulin, fasting plasma glucose, insulin and blood sugar of 2 hours after meal were analyzed before and after therapy, and 10 patients of OSAHS were untreated by MUPPP or CPAP. The other 33 cases of non-OSAHS were selected as control group. According to the model of HOMA and the formula of LiGuangwei,insulin resistance index and insulin sensitivity index were calculated, respectively.@*RESULT@#There were significant differences between OSAHS group before treatment and control group, before and after treatment, after treatment and untreated group (P < 0.01 or P < 0.05). There was very significant correlation between IAI and LSaO2 (r = 0.633),and there was significantly negative correlation between IAI and AHI (r = -0.654).@*CONCLUSION@#OSAHS is an important risk factor for the development of insulin resistance. It shows that OSAHS may develop IR of the patients and the treatment of MUPPP and CPAP can improve insulin sensitivity.

Retrospective analysis of the therapeutic studies on obstructive sleep apnea-hypopnea syndrome in the past ten years in our country / 中国耳鼻咽喉头颈外科

OBJECTIVE To summarize and evaluate the therapeutic studies on obstructive sleep apnea-hypopnea syndrome(OSAHS)in our country. METHODS Articles of therapeutic studies on OSAHS published in major journals of our country from Jan. 1995 to Dec. 2004 were evaluated retrospectively. RESULTS A total of 201 articles were recruited. The number of articles published every year was increased with time and most of the articles were retrospective study. There were no standard criteria for evaluating the curative effect,and the cure rate of UPPP were obviously different according to different evaluation criteria. In same evaluation criteria,the short- term outcome were better than long-term outcome,and the patients underwent multiple levels surgery had better outcome than single UPPP. CONCLUSION Multi-center,large sampled and prospective random comparison therapeutic study based on evaluative criteria constituted by Chinese Medical Association should be carried out in the future study. The impersonal methods and criteria for evaluation the upper airway anatomic structure and pharyngeal wall resilience should be established. Individuality therapy should be done. And finally, bring on therapeutic effect of OSAHS to a higher level in our country.

The lingual region upper airway CT scan of obstructive sleep apnea patients / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To compare the lingual region upper airway CT scan results of OSAS patients and normal adults to explore if there are upper airway stricture in OSAS patients and the reason of stricture.</p><p><b>METHODS</b>59 patients with OSAS and 57 normal adults were included in the study. CT evaluated the lingual region upper airway with the use of a Philips Tomoscan AV Expander E1 spiral scanner. The shapes of lingual region upper airway were observed. The area and the dimensions of lingual region was studied, and the thickness of retropharyngeal and lateral pharyngeal tissue were evaluated too. The another focus area was tongue, and the evaluated data included the tongue width, genioglossus width, hyogolssus width, tongue length and tongue area.</p><p><b>RESULTS</b>The data comparative results of OSAS and normal groups were as follows: the right to left diameter and area of OSAS patients' lingual region upper airways were less than those of normal adults, the thickness of lateral pharyngeal, tongue width, genioglossus width, hyogolssus width and tongue area were more than those of normal adults. And there were not obviously difference between OSAS patients and normal adults in tongue length, anterior-to-posterior dimension and thickness of retropharyngeal wall tissue of upper airway.</p><p><b>CONCLUSIONS</b>The study suggests that there are obviously difference between the patients with OSAS and normal adult in lingual upper airway CT scan measure. And the anatomic stricture of lingual upper airway is one of the etiology of OSAS. The main reasons of stricture are increasing of thickness of lateral pharyngeal, tongue width, genioglossus width, hyogolssus width and tongue area.</p>