Three-dimensional anatomical characteristics of airway and mandible and anesthetic intubation in patients with obstructive sleep apnea hypopnea syndrome

doi:10.13418/j.issn.1001-165x.2019.05.004

Chinese Journal of Clinical Anatomy ›› 2019, Vol. 37 ›› Issue (5) : 498-502. DOI: 10.13418/j.issn.1001-165x.2019.05.004

JI Xue-xia¹, QIU Qian-qi², ZHOU Guo-bin¹, MA Jue¹, JI Wen-jin¹, WANG Zhi-peng¹, WANG Sheng¹

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Abstract

Objective　To evaluate the three-dimensional anatomical characteristics of airway and mandible, the methods and times of anesthesia intubation in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods　30 patients with normal airway and 30 patients with OSAHS airway who underwent general anesthesia in our hospital and had been scanned by head and neck spiral CT from March 2016 to March 2019 were collected. Dolphin software was used to reconstruct and analyze the airway of the patients. The three-dimensional reconstruction and measurement of the mandible were performed. At the same time, the methods and times of anesthesia intubation were recorded. Results The airway volume, sagittal minimum cross section area, horizontal minimum cross section area and coronal minimum cross section area in OSAHS patients were significantly lower than those in normal patients (P<0.05). The mandibular distance of OSAHS patients was lower than that of normal patients, and the difference was statistically significant (P<0.05), whereas the angle of mandible was not significantly different from that of normal patients (P>0.05). The methods and times of anesthesia intubation in OSAHS patients were significantly different from those in normal patients (P<0.05). Conclusion　There are significant differences in three-dimensional anatomical characteristics of airway and mandible in patients with OSAHS. The anatomical characteristics of airway and mandible can be used as a reference for airway evaluation and endotracheal intubation before general anesthesia.

Key words

Obstructive sleep apnea hypopnea syndrome / 　Mandible / 　Intubation

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JI Xue-xia, QIU Qian-qi, ZHOU Guo-bin, MA Jue, JI Wen-jin, WANG Zhi-peng, WANG Sheng. Three-dimensional anatomical characteristics of airway and mandible and anesthetic intubation in patients with obstructive sleep apnea hypopnea syndrome[J]. Chinese Journal of Clinical Anatomy. 2019, 37(5): 498-502 https://doi.org/10.13418/j.issn.1001-165x.2019.05.004

References

[1] Apfelbaum JL, Hagberg CA, Caplan RA, et al. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway[J]. Anesthesiology, 2013,118(2): 251-270.
[2] Cook TM, Woodall N, Frerk C. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia[J]. Br J Anaesth, 2011,106(5): 617-631.
[3] Cook TM, Woodall N, Harper J, et al. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 2: intensive care and emergency departments[J]. Br J Anaesth, 2011, 106(5): 632-642.
[4] Stuginski-Barbosa J, Porporatti AL, Costa YM, et al. Agreement of the International Classification of Sleep Disorders Criteria with polysomnography for sleep bruxism diagnosis:A preliminary study[J]. J Prosthet Dent, 2017, 117(1): 61-66.
[5] Gale SD, Hopkins RO. Effects of hypoxia on the brain: neuroimaging and neuropsychological findings following carbon monoxide poisoning and obstructive sleep apnea[J]. J Int Neuropsychol Soc, 2004,10(1): 60-71.
[6] Al Lawati NM, Patel SR, Ayas NT. Epidemiology, risk factors, and consequences of obstructive sleep apnea and short sleep duration[J]. Prog Cardiovasc Dis, 2009, 51(4): 285-293.
[7] 张庆泉, 王强, 蔡晓岚, 等. 重症阻塞性睡眠呼吸暂停低通气综合征患者死亡原因分析[J]. 中华耳鼻咽喉头颈外科杂志, 2010, 45(5): 364-368.
[8] Kim YJ, Hong JS, Hwang YI, et al. Three-dimensional analysis of pharyngeal airway in preadolescent children with different anteroposterior skeletal patterns[J]. Am J Orthod Dentofacial Orthop,2010, 137(3): 306.e1-11.
[9] Hong JS, Oh KM, Kim BR, et al. Three-dimensional analysis of pharyngeal airway volume in adults with anterior position of the mandible[J]. Am J Orthod Dentofacial Orthop,2011,140(4): e161-169.
[10]Degerliyurt K, Ueki K, Hashiba Y, et al. A comparative CT evaluation of pharyngeal airway changes in class III patients receivingbimaxillary surgery or mandibular setback surgery[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2008, 105(4): 495-502.
[11]Seo SH, Lee JG, Yu SB, et al. Predictors of difficult intubation defined by the intubation difficulty scale (IDS): predictive value of 7 airway assessment factors[J]. Korean J Anesthesiol ,2012, 63(6): 491-497.
[12]McPherson D, Vaughan RS, Wilkes AR, et al. A survey of anaesthetic practice in predicting difficult intubation in UK and Europe[J]. Eur J Anaesthesiol, 2012, 29(5): 218-22.
[13]Ulusoy C, Canigur Bavbek N, Tuncer BB, et al. Evaluation of airway dimensions and changes in hyoid bone position following class II functional therapy with activator[J]. Acta Odontol Scand, 2014, 72(8): 917-925.
[14]王幸双, 汪小海, 李文媛, 等. 上呼吸道矢状面解剖学特点与声门暴露程度及插管次数的关系[J]. 临床麻醉学杂志, 2013, 29(12): 1174-1178.
[15]冯春英, 刘明, 李莹, 等. 阻塞性睡眠呼吸暂停低通气综合征的MRI研究[J]. 中国临床解剖学杂志, 2006, 24(4): 465-467.
[16]谢雨晨, 陈文栋, 马莉. 困难气道患者三维有限元模型解剖差异的分析[J]. 中国组织工程研究, 2019, 23(4): 562-566.
[17]Shah PN, Sundaram V. Incidence and predictors of difficult mask ventilation and intubation[J]. J Anaesthesiol Clin Pharmacol, 2012, 28(4): 451-455.