舌骨位置与多导睡眠监测指标及腭咽成形术后疗效相关性分析
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武汉大学人民医院 耳鼻咽喉头颈外科

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湖北省卫生健康委科研面上项目(No: WJ2021M140)


Correlation analysis of hyoid bone position with polysomnography data and prognosis of modified uvulopalatopharyngoplasty
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Department of Otolaryngology Head and Neck Surgery,Renmin Hospital of Wuhan University,Wuhan

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    摘要:

    目的 研究阻塞性睡眠呼吸暂停(OSA)患者舌骨位置与多导睡眠监测(PSG)指标以及腭咽成形手术疗效相关性,探讨舌骨位置对OSA疾病程度及腭咽成形手术预后的影响。

    Abstract:

    Objective To study the relationship between hyoid bone position and PSG data and the prognosis of modified uvulopalatopharyngoplasty (H-UPPP) in OSA patients, and to explore the influence of hyoid bone position in maxillofacial CT images on severity of OSA and prognosis of H-UPPP. Methods Preoperative hyoid bone position in maxillofacial CT images and preoperative and postoperative PSG data of 47 OSA patients who underwent H-UPPP from June 2020 to October 2021 were collected.SThe vertical distance from the mandible menton to the lower margin of the hyoid bone (MH-v), the horizontal distance from the mandible mental spine to the hyoid bone (MH-h), and the Friedman tongue position (FTP) was conducted correlation analysis with AHI, AvSpO2 (mean oxygen saturation), LSpO2 (lowest oxygen saturation) and the CT90 (ratio of cumulative time of oxygen saturation below 90% to total sleep time) in PSG respectively.SThe correlation between MH-v or FTP and prognosis of H-UPPP was further analyzed. Results MH-v was moderately correlated with AHI, LSpO2 and AvSpO2 (r=0.540, P=0.000;Sr= 0.523, P=0.000;Sr=-0.514, P=0.000), MH-v was weakly correlated with CT90 (r=0.495, P=0.000).SMH-h had no correlation with the above polysomnography data (P> 0.05).S FTP was weakly correlated with AvSpO2, LSpO2, CT90 and AHI (r=-0.370, P=0.01; r=-0.309, P=0.034; r=0.325, P=0.026; r=0.329, P=0.024).SThere was a statistically significant difference in MH-v between the effective and ineffective groups after H-UPPP (t=5.908, P=0.000), while there was no statistically significant difference in FTP between the two groups (U=258.5, P=0.693). The area under ROC curve of MH-v was 0.884,Swhich has moderate diagnostic value in predicting the effectiveness of H-UPPP surgery. Conclusions As an anatomic factor affecting OSA patients, the vertical distance from mandible menton to the lower margin of the hyoid bone (MH-v) has a higher correlation with PSG data than FTP,which is of certain value in predicting the effectiveness of H-UPPP surgery.

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  • 收稿日期:2022-04-19
  • 最后修改日期:2022-06-16
  • 录用日期:2022-06-17
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