中高阻塞性睡眠呼吸暂停风险患者的杓状软骨不对称：一项回顾性分析
Arytenoid Asymmetry in Patients with Moderate-to-High Risk of Obstructive Sleep Apnea: A Retrospective Analysis.
文献信息
| PMID | 42722547 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Abdul-Latif Hamdan |
| 作者单位 | Department of Otolaryngology-Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon. |
| 期刊 | Journal of voice : official journal of the Voice Foundation |
| SCI 分区 | Q1 |
| IF | 2.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 探讨中高阻塞性睡眠呼吸暂停（OSA）风险患者在发声过程中杓状软骨不对称（AA）的患病率。
研究设计： 回顾性病历审查
方法： 回顾了2022年6月至2022年12月期间连续就诊于睡眠呼吸暂停门诊的患者的病历和视频记录。使用STOP-BANG问卷评估OSA风险。纳入按年龄和性别匹配、无睡眠障碍病史的健康受试者作为对照组。人口学数据包括年龄、性别、体重指数（BMI）、吸烟史和声音嘶哑史。主要结局指标包括三种AA体征：小角软骨不对称、楔状软骨不对称以及杓会厌襞角度不对称。
结果： 本研究共纳入64例被转诊为中高OSA风险的患者（称为研究组）和54例无睡眠障碍者（称为对照组）。研究组和对照组的平均年龄分别为43.9±12.9岁和41.2±14.4岁。研究组与对照组在发声过程中AA的患病率方面存在显著差异（P < 0.001）。在多变量logistic回归模型中调整年龄、BMI、吸烟状况、性别和声音嘶哑史后，这一差异仍具有统计学意义（校正P = 0.002，95% CI：0.004-0.295）。与无睡眠障碍病史的对照组相比，中高OSA风险患者发生AA的可能性是对照组的10倍（OR = 10.0，95% CI = 3.53-28.57）。与对照组相比，所有三种杓状软骨不对称的患病率差异均具有统计学意义（分别为P = 0.002；P = 0.009；P = 0.045）。AA与声音嘶哑患病率之间存在弱且无显著意义的相关性（相关系数 = 0.159，P = 0.089）。
结论： 本研究结果表明，与无睡眠障碍病史的健康对照组相比，中高OSA风险患者在发声过程中AA的患病率显著更高。未来有必要研究中高OSA风险患者中AA与发声症状及发音困难之间的相关性。
英文摘要
OBJECTIVE: To investigate the prevalence of arytenoid asymmetry (AA) during phonation in patients with moderate-to-high risk of OSA.
STUDY DESIGN: Retrospective chart review METHODOLOGY: The medical records and video recordings of consecutive patients who presented to the sleep apnea clinic between June 2022 and December 2022 were reviewed. The risk of OSA was assessed using the STOP-BANG questionnaire. Healthy subjects with no history of sleep disorders matched by age and gender were included as a control group. Demographic data included age, gender, body mass index (BMI), history of smoking and history of hoarseness. The primary outcome measures included three signs of AA: asymmetry of the corniculate cartilage, asymmetry of the cuneiform cartilage, and asymmetry in the aryepiglottic fold angle.
RESULTS: Sixty-four patients with a moderate-to-high risk of OSA referred to as the study group, and 54 with no sleep disorders referred to as the control group, were included in this study. The mean age of the study and control groups were 43.9±12.9 and 41.2±14.4 years, respectively. There was a significant difference in the prevalence of AA during phonation between the study group and controls (P < 0.001). This difference remained statistically significant after adjusting for age, BMI, smoking status, gender and history of hoarseness in a multivariable logistic regression model (adjusted P = 0.002, 95% CI: 0.004-0.295). Patients with moderate-to-high risk of OSA were 10 times more likely to have AA in comparison to controls with no history of sleep disorders (OR = 10.0, 95% CI = 3.53-28.57). When compared to the control group, the difference in the prevalence of all three arytenoid asymmetries was statistically significant (P = 0.002; P = 0.009; P = 0.045, respectively). There was a weak and nonsignificant correlation between AA and the prevalence of hoarseness (correlation coefficient = 0.159, P = 0.089).
CONCLUSION: The results of this investigation indicate a significantly higher prevalence of AA during phonation in patients with moderate-to-high risk of OSA in comparison to healthy controls with no history of sleep disorders. Future investigations on the correlation between AA and phonatory symptoms in patients with moderate-to-high risk of OSA and dysphonia are warranted.