| Project/Area Number |
04404066
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| Research Category |
Grant-in-Aid for General Scientific Research (A)
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| Allocation Type | Single-year Grants |
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| Research Field |
Otorhinolaryngology
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| Research Institution | AKITA UNIVERSITY |
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Principal Investigator |
TOGAWA Kiyoshi AKITA UNIVERSITY FACULTY OF MEDICINE PROFESSOR, 医学部, 教授 (40009444)
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| Co-Investigator(Kenkyū-buntansha) |
ITASAKA Yoshiaki REGISTERED TECHNICIAN, 医学部, 教務職員 (80223072)
YOKOMIZO Michinori ASSISTANT PROFESSOR, 医学部, 助手 (70260453)
YAMAKAWA Koji ASSISTANT PROFESSOR, 医学部, 助手 (40191209)
MIYAZAKI Soichiro ASSISTANT PROFESSOR, 医学部, 助手 (20200157)
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| Project Period (FY) |
1992 – 1994
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| Project Status |
Completed (Fiscal Year 1994)
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| Budget Amount *help |
¥31,000,000 (Direct Cost: ¥31,000,000)
Fiscal Year 1994: ¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 1993: ¥7,000,000 (Direct Cost: ¥7,000,000)
Fiscal Year 1992: ¥21,000,000 (Direct Cost: ¥21,000,000)
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| Keywords | Obstructive sleep apnea syndrome / Snoring / Intraesophageal pressure / Upper airway pressure / Uvulopalatopharyngoplasty / Diagnosis of the site of obstruction / Body position / Obesity / 舌根正中切除術 / 呼吸生理 / 睡眠時無呼吸症 / 自動脳波解析装置 / ポリソムノグラフィー / 多点圧センサー / 軟口蓋 / 舌根 / 喉頭 |
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| Research Abstract |
A series of study on pathophysiology, diagnostic procedures and treatments of obstructive sleep apnea syndrome (OSAS) have been performed for three years, from 1992 to 1994. For the analysis of pathophysiological behaviors of OSAS,full study of polysomnography with the topographic evaluation of the upper airway obstruction was carried out. An EEG-autoanalyzer (DEE-1100) was introduced for prompt analysis of sleep conditions (stages non-REM and REM). A 4-channel pressure sensor was used to evaluate the sites of airway stenosis by measuring the pressure at the levels of epipharynx, mesopharynx, hypopharynx and esophagus. Topographically, the level of soft palate was 30%, that of tongue base was 30%, the combination of the two was 40%.
By applying nasal CPAP on the 76 patients while the intraluminal pressures were recorded, many cases of the combined type (total 37)moved either to the palatal type (19) or to the root of tongue type (11). 9 cases remained in the same type. Positional change from lying on the back to lateral in 54 cases, reduced the apnea index (AI) in the majority, whereas the reduction over 50% in amplitude of the intraesophageal pressure-change was in less percentage. Snoring sound was analyzed using a sound analyzer in relation to the site of airway obstruction. The fundamental frequency of snoring in vibratory type has 150Hz or less with some resonance. In stenotic type, it showed higher pitch with more noise component. UPPP gave better results in the vibratory type than in the stenotic type.
Various methods in the treatment to OSAS were compared based on the ratio of decrease in apnea index. After UPPP 60.7%, after UPPP+midline partial glossectomy 41.2%, mandibular prosthesis 55.7%, lateral positioning 76.1%. Surgeries did not necessarily give better results as the candidates have worse physical condition than those of conservative treatment, both in local and general.
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