以經皮超音波測量舌根位置

Transcutaneous Ultrasound for Measurement of the Tongue Base Position

范振華(Jen-Hua Fan) ； 張淳翔(Chun-Hsiang Chang) ； 黃執中(Chih-Chung Huang) ； 陳正文(Jeng-Wen Chen)

《台灣耳鼻喉頭頸外科雜誌》 47卷1期 (2012/02) Pp. 50-55

https://doi.org/10.6286/2012.47.1.50

摘要

背景：針對打鼾及阻塞性睡眠呼吸中止症患者舌根後區呼吸道是否阻塞及塌陷程度，臨床上目前尚無理想的評估工具，本描述性研究提出以非侵襲性的超音波評估舌根後區呼吸道塌陷程度的可行性。方法：10名受測者，5名男性5名女性，仰臥接受超音波檢查，超音波探頭置於下顎骨與舌骨之間的正中線矢狀平面上，比較正常呼吸時及Mueller maneuver時，頸部皮膚表面至舌根部空氣黏膜介面（air-mucosa interface）最長距離（skin-tongue base, S-TB）間的變化。結果：受測者平均年齡30.1 ± 4.8歲，平均身高168.8 ± 8.0 cm，平均體重65.2 ± 13.8 kg，平均BMI為22.7 ± 3.1 kg/m2，Epworth嗜睡量表的平均分數為4.4 ± 2.2，正常呼吸時平均S-TB為57.1 ± 4.1 mm，Mueller maneuver時平均S-TB為54.9 ± 4.6 mm，S-TB於正常呼吸及Mueller maneuver時的平均變化量為4.3 ± 3.2 mm。結論：超音波可觀察到仰臥時舌根後區呼吸道型態學上的變化，藉由記錄此變化量的大小，未來可作為打鼾及阻塞性睡眠呼吸中止症患者舌根後區呼吸道是否阻塞及塌陷程度之輔助評估工具。（台耳醫誌　2012; 47:50-55）

關鍵字

超音波 ； 阻塞性睡眠呼吸中止 ； Mueller操作 ； 舌根後區呼吸道 ； 空氣黏膜介面

並列摘要

BACKGROUND: There are presently no ideal clinical tools to assess whether patients with primary snoring or obstructive sleep apnea have obstructed retroglossal airways and evaluate the collapsibility. This descriptive study proposes the feasibility of using a non-invasive ultrasound to assess the collapsibility of the retroglossal airway.METHODS: Ten volunteer participants (five male and five female) received ultrasound examinations while in a supine position. The ultrasonic probe was placed on the midsagittal plane between the mandible and the hyoid bone. Changes in the longest distance between neck skin and tongue base air-mucosa interface (skin-tongue base, S-TB) during regular breathing and the Mueller maneuver were compared.RESULTS: The average age of subjects was 30.1 ± 4.8 years; average height was 168.8 ± 8.0 cm; average weight was 65.2 ± 13.8 kg, and average BMI was 22.7 ± 3.1 kg/m2 (18.7-30.0). Average score on the Epworth sleepiness scale was 4.4 ± 2.2 (1-9). The average S-TB was 57.1 ± 4.1 mm during regular breathing and 54.9 ± 4.6 mm during the Mueller maneuver. The average change in S-TB between regular breathing and the Mueller maneuver was 4.3 ± 3.2 mm (0.4-11.9).CONCLUSION: The ultrasound was capable of observing morphological changes in the retroglossal airway when subjects were in a supine position. The degree of these changes was recorded in this study. In the future, this information can be used as an aid in evaluating whether patients with primary snoring or obstructive sleep apnea have obstructed retroglossal airways, and in assessing collapsibility. (J Taiwan Otolaryngol Head Neck Surg 2012; 47:50-55)

並列關鍵字

ultrasound ； obstructive sleep apnea ； Mueller maneuver ； retroglossal airway ； air-mucosa interface