虚拟现实技术在OSAHS患者上气道形态学研究中的应用

目的探讨Dextroscope虚拟现实技术在阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hypopnea syndrome，OSAHS）患者上气道形态学研究中的应用。方法正常志愿者20人组成对照组，小下颌畸形伴重度OSAHS患者16人组成研究组。将对照组及研究组螺旋CT数据导入Dextroscope虚拟现实系统，重建融合建立上气道三维图像进行观察，定位上气道狭窄的区域。运用工作站中radiodexter软件，测量上气道各个层面的线距、横截面积并比较各区段的体积差异。根据研究组上气道狭窄的测量结果，对每一名患者选择相应的手术治疗方案，评估手术效果。结果研究组上气道直观狭窄区域主要为悬雍垂区及舌后区，也见于软腭后区，个别见于会厌后区。术后上气道在狭窄部位均明显扩大，上气道各区段的体积至少增大2倍以上，取得了很好的治疗效果。术前上气道腭咽体积为（3358．7±357．2）mm3，舌咽体积为（1910．7±215．7）mm3（P〈0．001）；术后腭咽体积为（13805．4±1876．3）mm3，舌咽体积为（5424．8±875．5）mm3（P〈0．001）。结论虚拟现实技术为OSAHS患者上气道狭窄的诊断提供了一种全新的方法。根据诊断结果指导手术治疗更加具有针对性，取到更好的的术后效果。

Application of virtual reality in morphological study on upper airway of OSAHS

Objective To evaluate the application of virtual reality in morphological study on upper airway in patients with OSAHS. Methods The sample was divided into two groups, control group and experimental group. Twenty normal volunteers were in control group and 16 micrognathic patients associated with OSAHS were in experimental group. Helical CT data of the control group and study group was imported to Dextroscope virtual reality system. Reconstruction of three-dimensional image of the upper airway was observed. The narrow area of upper airway was located. Using the radio dexter software, the line distance, the cross-sectional area and the volume of upper airway were calculated. According to the measurements of upper airway in the experimental group, the appropriate surgical treatment was selected for each patient to assess the effect of surgery. Results The intuitive narrow region of upper airway in the experimental group mainly occurred in the uvula region and lingual region, also found in the soft palate region. Postoperative upper airway was significantly expanded in the narrow region. The volume of velopharynx of the upper airway was increased from （3358. 7±357. 2）mm3 to （13805. 4±1876. 3） mm3 postoperation（P〈0. 001）. The volume of glossopharynx of the upper airway was increased from （1910. 7±215.7）mm3 to （5424. 8±875. 5）mm3 postoperation （P〈0. 001）. Conclusions Virtual reality for the diagnosis of narrow region of upper airway in patients with OSAHS provided a new approach. Based on the results, guiding surgical treatment was more specific and the better postoperative results could be achieved.