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Objective@#To investigate the effect of nasal cavity ventilation expansion techniques in treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) with nasal obstruction.@*Methods@#Thirty-two OSAHS patients with nasal obstruction hospitalized from January 2017 to January 2018 in Department of Otorhinolaryngology Head and Neck Surgery, Provincial Hospital Affiliated to Anhui Medical University were selected, with 28 males and 4 females, aged 40.3±8.5 years old (±s), and treated with individualized nasal cavity ventilation expansion techniques. Nasal acoustic reflex and resistance examination, polysomnography (PSG) monitoring were performed before and three months after operation. Nasal obstruction symptom evaluation (NOSE) and Quebec sleep questionnaire (QSQ) were completed as well. The nasal acoustic reflex, nasal resistance, NOSE, QSQ score, apnea hypopnea index (AHI) and lowest arterial oxygen saturation (LSaO2) before and after operation were compared and analyzed. SPSS 22.0 software was used for statistical analysis.@*Results@#After the operation, the total nasal resistance and total score of NOSE scale of patients decreased significantly as well as the total score of QSQ scale increased significantly ((0.140±0.043) kPa·s/L vs (0.277±0.067) kPa·s/L, 9.84±4.11 vs 53.00±11.57, 5.67±0.43 vs 3.86±0.46, t value was 10.687, 18.035, -16.904, respectively, all P<0.05), and the scores of five dimensions increased in varying degrees. Among the indexes of PSG, there was no significant difference in AHI and LSaO2 values before and after operation, but AHI decreased and LSaO2 increased.@*Conclusion@#Nasal cavity ventilation expansion techniques can effectively alleviate the symptoms of nasal obstruction in OSAHS patients and improve their sleep and quality of life.
RESUMO
[ABSTRACT]OBJECTIVETo compare the aerodynamic differences before and after nasal cavity ventilation expansion techniques in patients with OSAHS. METHODSA total of 30 adult patients with OSAHS were included in this study. Pre-operative upper airway CT of each subject was acquired. Each subject underwent surgery. Postoperative upper airway CT was obtained at least 3 months later. By means of CFD simulation method, numerical simulation was performed to calculate the airflow dynamic indexes of the upper airway. The pre-and post-operative aerodynamic characteristics were compared. RESULTSAfter operation, post-operative negative pressure nephogram of the nasal cavity indicated more smooth variation of pressure gradient, post-operative velocity nephogram of nasal cavity indicated slower airflow velocity. Proper values of flow field indicated the volume of nasal cavity increased significantly (t=4.025,P<0.01), the total nasal airway resistance decreased significantly (t=-2.065,P<0.01). The total negative pressure of the upper airway decreased significantly (t=-2.659,P<0.01) after operation. However, the proper values of flow field increased in 5 patients. CONCLUSIONNasal cavity ventilation expansion effectively increase the volumes of nasal cavity, improve the nasal ventilation, and reduce the air flow velocity of both nasal cavity and pharynx in OSAHS patients, those reduce the pharyngeal negative pressure and the pharyngeal collapse. However, for patients with its narrowest segment at the velopharyngeal level, operation cannot do anything or even aggravate the pharyngeal collapse. Operation should be performed individually.