The Morphometric And Qualitative Histopathologic Investigation Of Tensor Veli Palatini In Patients With Obstructive Sleep Apnea-hypopneasyndrome

Objective: Obstructive sleep apnea-hypopnea syndrome(OSAHS) is characterized by collapse and obstruction of upper airways during inspiration and sleep, and the upper airway mucosa of it is often described as edematous and hyperplastic, but the pathophysiological mechanism of upper airway collapsibility remains unclear. We study the morphometric and qualitative histopathologic changes of tensor veli palatini in OSAHS patients and compare them with that of chronic tonsillitis patients. Acording to the result, we may determine whether the neurogenic lesions could be a contributory factor.Methods: Biopsies were obtained uvulopalatopharyngoplasty in 30 patients with lightly to severe OSAHS. Control specimens of tensor veli palatini were retrieved in 10 patients with chronic tonsillitis and proved have no related disorders. The morphological alteration was evaluated using Trichrome HE, Masson staining, AchE histochemistry stain and transmission electron microscope(TEM). According to Traditional Chinese Medicine(TCM) dialectic criterions, sleep with snore patients were divided into phlegm-damp constitution (PDC) group and non-PDC group. Acording to the result, we could compare the difference and relation in two groups.Results: In OSAHS patients, the secars of myofibers were deseased, but the secars of collagen fibers were increased, the ratio of secars of myofibers to secars of collagen fibers was progressively decreased; TEM: The structure of myofibril confused, some myofilaments and part of the Z zones dissolved, some breaks disappeared, sarcoplasms dilated cystiformly and tubularly, the mitochondrias concentrated among the muscle fibers, the myelinated nerve fibers degenerated, the myelin sheath loosed and regional edema; The levels of AchE expression in myoceptors were deseased. There were differences between PDC and non-PDC group in the morphometric and qualitative histopathologic changes of tensor veli palatini. There were relationship between PDC and non-PDC group in the morphometric and qualitative histopathologic changes of tensor veli palatini. Conclusion: The myoceptors and nervus peripheralis of tensor veli palatini in OSAHS patients have great morphologically changed. The denervation of tensor veli palatini may plays an importpart role in etiopathogenesis of OSAHS. The PDC may result in sleep with snore. There are conspicuous relationship between the severity of sleep with snore and PDC.