Tıkayıcı uyku apnesi olgularında kulak burun boğaz muayene bulguları
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Dosyalar
Tarih
2015
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda, devamlı pozitif havayolu basıncı titrasyonu öncesinde tıkayıcı uyku apnesi sendromlu hastalarda kulak burun boğaz patolojilerinin sıklığını araştırmayı amaçladık. Prospektif olarak yaptığımız çalışmada tıkayıcı uyku apnesi sendromu tanısı alan devamlı pozitif havayolu basıncı titrasyonu endikasyonu olan 55 olgu değerlendirildi. Bu hastaların nazal havayolu subjektif ve objektif olarak değerlendirildi ve diğer kulak burun boğaz muayeneleri yapıldı. Bu muayene bulgularının sıklığını araştırdık ve birbirleri ile olan korelasyonunu inceledik. Nazal değerlendirmede kullandığımız objektif değerlendirme yöntemlerinden olan akustik rinometrik ölçüm sonucunda bu olguların %89'unda, subjektif değerlendirme yöntemi olan endoskopik değerlendirme sonucunda %83,63'nde en az bir havayolunda tıkanıklık saptanırken görsel analog skala değerlendirmesinde %20'sinde en az bir havayolunda tıkanıklık bulundu. Bu sonuçlar görsel analog skalanın nazal havayolu değerlendirmede güvenilir bir yöntem olmadığı, endoskopik muayene ve akustik rinometrik ölçümün nazal hava yolu değerlendirilmesinde daha doğru ve güvenilir sonuçlar verdiği sonucuna vardık. Ayrıca bu hastalarda ileri evre mallampati ve uzun uvula sıklığı normal popülasyona göre yüksek bulundu. Tonsil skoru, farengeal derecelendirme skoru ve makroglossi sıklığında normal popülasyondaki değerlerinden farklılık saptanmadı. Burun tıkanıklığı ve minimal cross-sectional area değerleri düşük olan hastalarda devamlı pozitif havayolu basıncı uyumunun az olduğu bilinen ve araştırmalar ile ispatlanmış bir durumdur. Bundan dolayıdır ki nazal muayene tıkayıcı uyku apne sendromu tanısı almış hastalarda devamlı pozitif havayolu basıncı cihazı almadan önce mutlaka yapılmalıdır. Hatta bu hastalara kulak burun boğaz hekimi değerlendirmeden devamlı pozitif havayolu basıncı cihaz raporu verilmemelidir.
Abstract
In our study, we have aimed to examine the frequency of ear nose and throat pathologies on the facts who have obstructive sleep apnea syndrome before continuous positive airway pressure titration.In our prospectively study we have evaluated 55 facts who have been diagnosed with the obstructive sleep apnea syndrome and have continuous positive airway pressure titration indication. Airways of these facts have been evaluated subjectively and objectively and their other ear nose and throat medical examinations have been done.We have examined the frequency of the examination facts and investigated the correlation in between each other. As a result of the acoustic rhinometry evaluation which is one of the objective evaluation methods we are using in nasal evaluation %89 of these facts and as a result of the endoscopic evaluation which is a subjective evaluation %83,63 of these facts have been detected to have at least one airway occlusion and after a visual analogue scale evaluation we have found out that the %20 of these facts have occlusion in at least one of their airways. We have come to conclusion that these results show us that visual analogue scale is not a reliable method in evaluating the nasal airway evaluation, endoscopic examination and acoustic rhinometry evaluation have given out truer and more reliable results in nasal airway evaluation. Furthermore, advanced mallampati and long uvula frequency are found to be higher than the normal population. It has not been detected that the tonsil score, pharyngeal gradation score and macroglossia frequency are different from the ones in normal population. It is a circumstance which is known and proven by research that continuous positive airway pressure adaptation is less in facts who has nasal congestion and low minimal cross-sectional area values. This is the reason why nasal examination should definitely be made on the patients who have been diagnosed with obstructive apnea syndrome before getting continuous positive airway pressure device. As a matter of fact that continuous positive airway pressure device report should not be given to these facts unless an otorhinolaryngologist makes an evaluation.
Abstract
In our study, we have aimed to examine the frequency of ear nose and throat pathologies on the facts who have obstructive sleep apnea syndrome before continuous positive airway pressure titration.In our prospectively study we have evaluated 55 facts who have been diagnosed with the obstructive sleep apnea syndrome and have continuous positive airway pressure titration indication. Airways of these facts have been evaluated subjectively and objectively and their other ear nose and throat medical examinations have been done.We have examined the frequency of the examination facts and investigated the correlation in between each other. As a result of the acoustic rhinometry evaluation which is one of the objective evaluation methods we are using in nasal evaluation %89 of these facts and as a result of the endoscopic evaluation which is a subjective evaluation %83,63 of these facts have been detected to have at least one airway occlusion and after a visual analogue scale evaluation we have found out that the %20 of these facts have occlusion in at least one of their airways. We have come to conclusion that these results show us that visual analogue scale is not a reliable method in evaluating the nasal airway evaluation, endoscopic examination and acoustic rhinometry evaluation have given out truer and more reliable results in nasal airway evaluation. Furthermore, advanced mallampati and long uvula frequency are found to be higher than the normal population. It has not been detected that the tonsil score, pharyngeal gradation score and macroglossia frequency are different from the ones in normal population. It is a circumstance which is known and proven by research that continuous positive airway pressure adaptation is less in facts who has nasal congestion and low minimal cross-sectional area values. This is the reason why nasal examination should definitely be made on the patients who have been diagnosed with obstructive apnea syndrome before getting continuous positive airway pressure device. As a matter of fact that continuous positive airway pressure device report should not be given to these facts unless an otorhinolaryngologist makes an evaluation.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Rinometri, Devamlı Pozitif Havayolu Basıncı, Uyku Apnesi, Burun Tıkanıklığı, Akustik, Tıkayıcı, Nasal Obstruction, Continuous Positive Airway Pressure, Sleep apnea, Obstructive, Rhinometry, Acoustic
