The Influence Of The Retrolingual Obstructionto The Patients With Obstructive Sleep Apnea Hypopnea Syndrome

Objective: To explore the cilinical and the outcomes of polysomnograhy (PSG) of the patients with obstructive sleep apnea hypopnea syndrome (OSAHS) with the retrolingual obstruction. And to explore the correlation between the incidence of the retrolingual obstruction and the age and the obesity.Methods: The dates of the upper airway obstruction and the outcomes of polysomography were collected from 230 OSAHS patients which were diagnosised definitely by PSG All these patients had symptoms of snoring, choking, gasping at night and were sleepy during the daytime. And the patients with upper airway resistance syndrome, asthma, copd, sinus disease, prior upper airway surgery, left-heart failure, addiction to drugs or alcohol were excluded. A complete physical examination was followed by an ear, nose, and throat examination, which included the examination using flexible fiberoptic endoscope and video recorder equipment and the muller's maueuver. Then all the patients were examined and had a full-night polysomography. The datas of the nasopharyngeal obstruction, the oropharygngeal obstruction, the retrolingual obstruction and the outcomes of PSG were collected. We divided all the patients into two groups: those with retroligual obstruction (including mild OSAHS 26, moderate OSAHS 18,severe OSAHS 76);and those without it(including mild OSAHS 26, moderate OSAHS 24, severe OSAHS 60). The age, body mass index (BMI) and the main outcomes of PSG are expressed as mean values±standard deviation from the mean. The student's t-test and the Wicoxon signed rank test were used to compare the two groups's date by SPSS 10.0.Results: (1) All 230 patients had oropharynx obstruction and 120 of 230 patients had retrolingual obstruction. There are 53 patients with nasal obstruction in those patients with retrolingual obstruction. (2) there are 220 males and 10 males, including mild OSAHS 52, moderate OSAHS 42,severe OSAHS 136. age arrange from 20 to 68 years, the body mass index varing from between 18 to 54 kg / m~2,the percentage of the obesity is 69%. (3) The group with retrolingual obstruction had a higher age, a higher percentage of time in non-rapid eye movement (NREM) sleep 1 phase and a higher apnea index (AI) but the percentage of time in NREM stage sleep 2 phrase, the hypopnea index (HI) were lower. There was no significant difference in the body mass index (BMI), the percentage of time in NREM sleep 3 phrase, the percentage of time in the NREM sleep 4 phrase, the percentage of time in the rapid eye movement (REM) sleep phrase, the apnea hypopnea index (AHI), the lowest oxygen situation level, the longest event with apnea or hypopnea, and the total microarousal index (MI) between the two groups (P > 0.05).Conclusion: There are nasal obstruction or retrolingual obstruction except for the oropharynx obstruction in many OASHS patients. The incidence of the retrolingual obstruction is high. The BMI of a large partial of the OSAHS patients exceeds the normal extent. The age of the OSAHS patients with retrolingual obstruction is higher. The patients with retrolingual obstruction have a worse disturbance sleep. Their AI is higher and their HI is lower.