[Show abstract][Hide abstract] ABSTRACT: Objective:
To compare 256-layer spiral computed tomography (CT) scan in sleep and laryngofiberscope technology for locating obstructive sites of upper airway in patients with obstructive sleep apnea hypopnea syndrome, analyze their advantages and disadvantages and discuss the clinical application values.
A total of 59 patients with OSAHS diagnosed by polysomnography underwent spiral CT scan in awake and drug-induced sleep states and laryngofiberscope examination in awake state to assess the sites of airway obstruction.
Real-time CT scans were completed successfully in all patients. There were airway obstruction at isolated retropalatal region (real-time CT revealing n = 26, laryngofiberscope revealing n = 34), retropalatal and retroglottal regions simultaneously (real-time CT revealing n = 19, laryngofiberscope revealing n = 10), retropalatal and epiglottal regions simultaneously (real-time CT revealing n = 6, laryngofiberscope revealing n = 2), retropalatal and retroglottal and epiglottal regions simultaneously (real-time CT revealing n = 7, laryngofiberscope revealing n = 3) and no airway obstruction (real-time CT revealing n = 1, laryngofiberscope revealing n = 10). There was not solitary airway obstruction at retroglottal or epiglottal region. The results of real-time CT scans and laryngofiberscope examination were statistically significant different in all regions, and real-time CT scanning compared with laryngofiberscope found more obstructive sites of upper airway [retropalatal region: 98.3% (n = 58) vs 81.4% (n = 48), χ(2) = 5.82, P < 0.05; retroglottal regions: 44.1% (n = 26) vs 22.0% (n = 13), χ(2) = 9.60, P < 0.01; epiglottal regions: 22.0% (n = 13) vs 8.5% (n = 5), χ(2) = 4.90, P < 0.05].
Compared with laryngofiberscope examination,real-time dynamic CT scans in drug-induced sleep state could get more information about anatomy changes of upper airway, providing relatively objective morphological basis for diagnosis and treatment of patients with OSAHS.
No preview · Article · Dec 2012 · Zhonghua yi xue za zhi
[Show abstract][Hide abstract] ABSTRACT: To investigate the reliability and validity of the simplified Chinese version of Epworth sleepiness scale(ESS).
Five hundred and eighty-five patients with suspected obstructive sleep apnea hypopnea syndrome (OSAHS) and 103 OSAHS patients who underwent operations were included in this study. The ESS was filled before polysomnography (PSG) monitoring under the direction of professional technicians. The patients who underwent operations did both PSG and ESS tests more than 6 months after operation. Fifty-one patients who underwent PSG at our hospital from July to August, 2010 were chosen to assess the ESS test-retest reliability on two separate occasions at least more than one week.
The total Cronbach's Alpha of ESS was 0.814. The test-retest reliability of ESS total scores was 0.679 and for each item was from 0.473 to 0.698(P < 0.01). Split-half reliability was 0.817 (P < 0.01). In the analysis of discriminant validity with apnea hypopnea index (AHI), the ESS total scores and each item's scores had significant differences in severity in OSAHS patients and simple snoring patients (P < 0.05), and this was also true in different degrees of lowest saturation of arterial oxygen (LSaO(2)) patients and normal LSaO(2) patients (P < 0.05). The factor analysis of construct validity showed that 4 factors were extracted. The cumulative proportion was 74.270%. The loading was higher than 0.4 among every item. The correlation coefficiency of overall ESS scores and each item's scores was relatively high except the last item. The ESS had low consistency with clinical diagnosis(κ = 0.099, P < 0.01) and the predictive validity was not good (r = 0.138, P < 0.01).As for 103 patients who had operations, the initial assessment of total ESS scores were 15.0[10;20] (M[P(25); P(75)]), and improved to 4[1;6] after operation. The patients who got effective results had significant difference in the total ESS scores before and after operation (Z = -7.528, P < 0.01), so was the patients who got ineffective results (Z = -4.382, P < 0.01) .
The simplified Chinese version of ESS had a good reliability and validity. It can be used to evaluate the chance of dozing in the daytime.
No preview · Article · Jan 2011 · Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
[Show abstract][Hide abstract] ABSTRACT: To study the value of Epworth sleepiness scale in assessment of obstructive sleep apnea hypopnea syndrome (OSAHS) severity.
The polysomnography (PSG) data of 620 suspected OSAHS patients from Jan. 2000 to Dec. 2003 were retrospectively analyzed. There were 556 males and 64 females, and their age ranged from 21 to 79 years (median 45.0 years). Of the all 620 patients, the median of the weight was 82.0 kg ( range 50 to 130 kg), median of height was 172.0 cm (range 147 to 178 cm), median of body mass index was 28.0 (range 18.5 to 42.9), median of apnea-hypopnea index (AHI) was 37.2 (range 0 to 126.1), median of lowest arterial oxygen saturation (LSAT) was 0.75 (range 0.21 to 0.93), median of ESS was 13.0 (range 0 to 24). OSAHS was diagnosed in 513 patients and simple snorer was diagnosed in 107 patients by PSG. All the patients filled in ESS questionnaire in sleep disorder centre before PSG.
The correlation coefficients of the ESS and AHI, LSAT was -0.314 and -0.312 respectively (P <0. 05). The median of ESS in severe OSAHS group was higher than that in simple snorer, mild and moderate OSAHS groups (P < 0.001), but no difference was found among the simple snorer, mild and moderate OSAHS groups (P < 0.05). The median of ESS in severe hypoxemia group was higher than that in no, mild and moderate hypoxemia groups (P < 0.001), but no difference was found among no, mild and moderate hypoxemia groups (P > 0.05).
The Epworth sleepiness scale has little value in assessment of OSAHS severity. A new sleepiness scale method which is suitable for Chinese should be made.
No preview · Article · Apr 2007 · Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
[Show abstract][Hide abstract] ABSTRACT: To explore the appropriate study how to properly evaluate the hypoxemia degree in patients with obstructive sleep apnea/hypoventilation syndrome (OSAHS).
polysomnography was conducted on 108 OSAHS patients and 37 simple snorers to record the minimum oxygen saturation level (MiO(2)) and the total recorded time spent below 90% oxygen saturation (TS90%). The correlation between MiO(2) and the percent of the total recorded time spent below 90% oxygen saturation (TS90%) with the AHI were calculated.
The value of TS90% was significantly increased, and the value of MiO(2) was significantly decreased as the severity of OSAHS increased (all P < 0.001). The correlation coefficients of TS90% with AHI and with Epworth sleepiness scale (ESS) were both much higher than those of MiO(2).
TS90% can express the severity of hypoxemia of the OSAHS patients more correctly than MiO(2). TS90% combined with MiO(2) can comprehensively and objectively reflect the severity of hypoxia of the OSAHS patients.
No preview · Article · Nov 2005 · Zhonghua yi xue za zhi