The effect of upper airway structural changes on central chemosensitivity in obstructive sleep apnea-hypopnea.
We examined the efficiency of upper airway structural changes in uvulopalatopharyngoplasty and/or tonsillectomy on central chemosensitivity, and whether the outcome of such surgeries can be predicted by the central chemosensitivity in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients. In 11 patients with OSAHS group, the average of the hypercapnic ventilatory response (HCVR) slope was 1.93 +/- 0.20 L/min/mm Hg preoperatively and 1.78 +/- 0.22 L/min/mm Hg postoperatively. The average of the mouth occlusion pressure at 0.1 second after the onset of inspiration (P (0.1)) slope was 0.47 +/- 0.06 cm H (2)O/mm Hg and 0.44 +/- 0.08 cm H (2)O/mm Hg, before and after surgery, respectively. There were no significant differences before and after treatment, although OSAHS was improved by these surgeries. In control group with 5 patients, the HCVR slope and P (0.1) slope also showed no significant difference before and after the procedure. When we divided the 11 OSAHS patients into 7 responders (apnea-hypopnea index < 20 events/h and > 50% reduction) and 4 poor responders, there was a significant difference between the average HCVR slope of responders (1.59 +/- 0.21 L/min/mm Hg) and that of poor responders (2.52 +/- 0.20 L/min/mm Hg). We saw no significant difference in physiologic (age, body mass index, one-piece tonsil weight), blood gas values, cephalometric, spirometric, or sleep parameters.
Suzuki
Masaaki
M
Department of Otorhinolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. suzukima@med.teikyo-u.acjp
Ogawa
Hiromasa
H
Okabe
Shinichi
S
Yagi
Tomoko
T
Horiuchi
Atsushi
A
Okubo
Mau
M
Ikeda
Katsuhisa
K
Hida
Wataru
W
Kobayashi
Toshimitsu
T
D000328:Adult; D001784:Blood Gas Analysis / Q000295:instrumentation; D002628:Chemoreceptor Cells / Q000502:physiology*; D006801:Humans; D006935:Hypercapnia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D010160:Palate, Soft / Q000503:physiopathology* / Q000601:surgery*; D014066:Palatine Tonsil / Q000601:surgery*; D017286:Polysomnography / Q000379:methods; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D012894:Sleep Stages; D013147:Spirometry; D014068:Tonsillectomy; D014609:Uvula / Q000503:physiopathology* / Q000601:surgery*