硬腭缩短-腭咽成形术治疗阻塞性睡眠呼吸暂停综合征

[目的 ]探讨用硬腭缩短 腭咽成形术手术治疗阻塞性睡眠呼吸暂停综合征的疗效 .[方法 ]对114例正常成人颅骨硬腭进行解剖学测量并与 10例阻塞性睡眠呼吸暂停综合征患者术中测量的硬腭长度进行比较 ,又对 2 4例正常成人与 10例阻塞性睡眠呼吸暂停综合征病人的头侧位片头影测定的硬腭骨影长度进行比较 .[结果 ]阻塞性睡眠呼吸暂停综合征患者硬腭过长 ,硬腭缩短 腭咽成形术后腭后间隙的上口和最窄点的前后径及左右径均比术前明显扩大 ,Meuller氏法证明吸气时咽壁塌陷程度明显减轻 .[结论 ]硬腭缩短后软腭支点前移、上下运动度加大 ,这些均可能与硬腭缩短 腭咽成形术的良好疗效有关 .

Treatment of obstructive sleep apnea syndrome with hard palate shortening-uvulopalatopharyngoplasty

OBJECTIVE To explore the therapeutic mechanism of treating the obstructive sleep apnea syndrome with hard palate shortening uvulopalatopharyngoplasty(HPS UPPP). METHODS Anatomical measurement of the hard palates in 114 normal adult's skulls was performed. And then it was compared with the length of hard palates measured in operation in 10 cases of obstructive sleep apnea syndrome. Cephalometric comparison the length of hard palates between 24 cases of normal adults and 10 cases of obstructive sleep apnea syndrome was also made. RESULTS The length of hard palate in obstructive sleep apnea syndrome patients was obviously long. The pre and post operative cephalometric analysis was showed that the anteroposterior diameters at upper orifice and the narrowest point of postpalatal space and left right diameters of postpalatal space were significantly increased after the HPS UPPP. It was testified by Mueller's method that the collapse degree of pharyngeal wall during inspiration was significantly decreased. CONCLUSION The fulcrum of soft palate is forward displaced after hard palate shortening and the up and down motion extent of soft palate may be increased. Therefore it may be related to the good therapeutic effects of the HPS UPPP.