舌骨悬吊联合腭咽成形术前后舌咽平面X线头影测量

目的探讨应用X线测量舌骨悬吊联合腭咽成形术前后舌咽平面后气道间隙的变化,为治疗舌咽平面狭窄提供形态学依据。方法对30例经多导睡眠监测系统（polysomnography,PSG）、Müller＇s试验确定的舌咽平面和腭咽平面狭窄的中、重度OSAHS患者,同期行舌骨悬吊术联合腭咽成形术。术后随访,应用PSG及X线头影测量分析治疗效果。结果术后随访1年,呼吸紊乱指数从（63.00±11.23）下降到（19.00±4.52）,参照杭州会议OSAHS疗效评定标准,治愈12例（40.00%）,显效10例（33.33%）,有效3例（10.00%）,无效5例（16.67%）,总有效率83.33%。X线头影测量分析示舌骨向前上移位,后气道间隙扩大。结论舌骨悬吊术可通过向前上牵拉舌骨,扩大舌咽平面后气道间隙,达到治疗舌咽平面狭窄的部分OSAHS患者。

An analysis of the pre-operative and post-operative X-ray projection of patients with hyoid suspension and uvolopalatopharyngoplasty surgery

Objective To investigate the differences of airway space pre-operatively and post-operatively using X-ray projection in patients with hyoid suspension and uvolopalatopharyngoplasty surgeries and to provide a morphological basis for the treatment of glossopharyngeal stegnosis.Methods 30 patients with moderate or serious OSAHS were diagnosed with stegnosis both on glossopharyngeal and palatopharyengeal planes using polysomnography（PSG） and the Müller test.All patients underwent hyoid suspension and uvolopalatopharyngoplasty surgeries and a pre-and post-operative follow-up of one year,and PSG as well as X-ray projection were used to analyze the therapeutic efficacy.Results A one-year follow-up indicated that the apnea hyponea index decreased from 63±11.23 to 19±4.52.Based on the standard set up in the Hangzhou meeting,12 cases（40.00%） were healed,10（33.33%） had excellent effects,3（10.00%） had effects,and 5 had no effects（16.67%）,and the total effective rate was 83.33%.X-ray projection showed superior-anterior displacement of hyoid bones and enlarged posterior space.Conclusions Hyoid suspension surgery can treat patients with OSAHS suffering from glossopharyngeal stegnosis by dragging the hyoid bone anterior-superiorly to enlarge the airway space on the glossopharyngeal plane.