Clinical Evaluation Of Individualized Nasal Cavity Ventilation Expansion Techniques For The Treatment Of Obstructive Sleep Apnea-hypopnea Syndrome

Background:Sleep apnea is a kind of disease with high incidence,and obstructive sleep apnea hypopnea syndrome(OSAHS)is the most harmfu 1.At present,the incidence of OSAHS in China is increasing year by year.According to a number of studies,the prevalence rate of OSAHS in the general population is 3.6%-7.8%.It has become a common and fr equently-occurring disease,which seriously affects the health of the sick population.There are many causes and complex pathogenes is of OSAHS.With the continuous study of OSAHS disease,it is found that one of the main causes is the anatomical chara cteristics of upper respiratory tract obstruction induced by sleep.The upper respiratory tract is a conti nuous anatomic al structure.the stenosis and collapse of any plane can aff ect the ventilation of the upper respiratory tract,and the anatomic stenosis plane can be located in the nose,orophary nx or laryngopharynx.In recent years,with the deepening of research,people pay more and more attention to the obstruc tion of upper respiratory tract as an important influence of source disease.The stenosis of nasal cavity can cause the increase of nasal resistance,the increase of negative inspi ratory pressure of pharyngeal cavity,the collapse of soft p alate and the narrowing of pharyngeal cavity,which can be t he starting factors of upper respiratory tract obstruction.Therefore,more and more attention has been paid to the trea tment of OSAHS by nasal surgery.with the development and po pularization of nasal endoscopic technology,there are many reports on nasal dilatation in the treatment of nasal OSAHS,but they are different and controversial.The main controve rsy focuses on the improvement of surgical efficiency and ob jective indicators,so this study focuses on individualized nasal dilatation in patients with rhinogenic OSAHS.The effec tive rate and objective index of treatment were analyzed and studied in order to provide reference for clinical treatmen t.ObjectiveTo investigate the efficacy of individualized nasal cavity ventilation expansion techniques for obstructive sleep apnea-hypopnea syndrome(OSAHS)patients with nasal obstruction.MethodsBetween January 2018 and June 2019,42 adult OSAHS patients with nasal obstruction were selected and treated at the Qilu Hospital of Shandong University(Qingdao).Polysomnogram(PSG),nasal acoustic reflex,resistance examination,and nasal respiration volume were performed before and 3 months after surgery to record the apnea hypopnea index(AHI),the lowest arterial oxygen saturation(LSa02),nasal minimal cross-sectional area(NMCA),nasal cavity volume(NCV),nasal airway resistance(NAR),and nasal total volume(VT).The nasal obstruction symptom evaluation(NOSE)and Epworth sleepiness scale(ESS)were also administered.Continuous positive airway pressure(CPAP)was performed before surgery;the acceptance of CPAP treatment was recorded using the visual analog scale(VAS).The average effective treatment pressure was assessed using the manual pressure titration,and it was reviewed 3 months after the surgery to analyze the effect of nasal dilatation.ResultsThree months after the surgery,the scores of NOSE,ESS,and VAS fo r all the patients were significantly lower than those obtained befor e the surgery(4.52±1.770vs12.43±2.855;7.55±2.144vs12.67±2.205;7.42±1.02vs4.92±1.38,P<0.05).Subjective nasal congestion and somno lence significantly resolved in all the patients.Among the objective indexes,NMCA,NCV,and VT increased significantly,and the average effective pressure of NAR and CPAP decreased significantly(P<0.05).AHI was lower and LSa02 was higher in patients with mild and moderat e OSAHS after than before the surgery[Mild:10.76 ±2.74 times/h vs6.27±2.34 times/h,76.44±2.63%vs82.0±2.80%;Moderate:25.12±5.32 time s/h vs17.38±6.51times/h,70.92±3.17%vs73.85±3.31%,P<0.05].Conclusion1.Individualized nasal dilatation can effectively improve nasal ventilation and the sleep quality of OSAHS patients with nasal congestion symptoms2.Individualized nasal dilatation is an effective surgical method for the treatment of nasal OSAHS,and it can improve compliance with CPAP treatment.3.Multifaceted comprehensive treatments are needed for moderate and severe OSAHS cases.