Han Demin, Zhang Luo
Department of Otolaryngology, National Key Discipline, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Acta Otolaryngol. 2011 Dec;131(12):1244-8. doi: 10.3109/00016489.2011.615760. Epub 2011 Oct 23.
Nasal cavity ventilation expansion surgery has been progressively developed alongside an advanced understanding of the pathophysiological mechanisms of sleep-disordered breathing and the maturation of endoscopic surgery techniques. Nasal cavity ventilation expansion surgery could increase the ventilation volume of the nasal cavity effectively and decrease the nasal resistance, relieve the upper airway obstruction, and finally remove the original obstructive factor in the upper airway obstruction. The major significance of these procedures is to decrease the pre-ventilation resistance of the upper airway, to relieve pharyngeal collapse, to recover normal ventilatory function, to promote physical recovery, to re-establish normal metabolic functions, and to restore sleep structure. Nasal cavity ventilation expansion surgery includes a series of procedures and to open nasal sinuses symmetrically could decrease the nasal resistance, relieve the upper airway obstruction, and finally remove the original obstructive factor in the upper airway obstruction. The application of endoscopic surgery to obstructive sleep apnea (OSA) enhances the ventilation volume and symmetry of nasal cavity ventilation and has expanded the range of indications for which functional endoscopic sinus surgery (FESS) is effective. Combined with H-uvulopalatopharyngoplasty (H-UPPP), the outcome of surgical treatment on ventilation disorders of the upper airway obstruction and the symptoms of OSA will both be improved.
随着对睡眠呼吸障碍病理生理机制的深入理解以及内镜手术技术的成熟,鼻腔通气扩张手术得到了逐步发展。鼻腔通气扩张手术能够有效增加鼻腔通气量,降低鼻阻力,缓解上气道阻塞,最终消除上气道阻塞的原有阻塞因素。这些手术的主要意义在于降低上气道的预通气阻力,缓解咽部塌陷,恢复正常通气功能,促进身体恢复,重建正常代谢功能,以及恢复睡眠结构。鼻腔通气扩张手术包括一系列操作,对称打开鼻窦可降低鼻阻力,缓解上气道阻塞,最终消除上气道阻塞的原有阻塞因素。内镜手术在阻塞性睡眠呼吸暂停(OSA)中的应用增加了鼻腔通气的通气量和对称性,并扩大了功能性内镜鼻窦手术(FESS)有效的适应证范围。与悬雍垂腭咽成形术(H-UPPP)联合应用,对上气道阻塞通气障碍的手术治疗效果以及OSA的症状都将得到改善。