Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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The Effect of Mandibular Protrusion on Dynamic Changes in Oropharyngeal Caliber

하악의 전방이동이 구인두 내경의 동적 변화에 미치는 영향

  • Jung, Jae-Kwang (Department of Oral Medicine, School of Dentistry, Kyungpook National University) ;
  • Hur, Yun-Kyung (Department of Oral Medicine, School of Dentistry, Kyungpook National University) ;
  • Choi, Jae-Kap (Department of Oral Medicine, School of Dentistry, Kyungpook National University)
  • 정재광 (경북대학교 치의학전문대학원 구강내과학교실) ;
  • 허윤경 (경북대학교 치의학전문대학원 구강내과학교실) ;
  • 최재갑 (경북대학교 치의학전문대학원 구강내과학교실)
  • Received : 2010.07.05
  • Accepted : 2010.07.31
  • Published : 2010.09.30
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Abstract

The purpose of this study was to determine the sites of narrowing/obstruction and to measure the regional severity of narrowing through the evaluation of dynamic changes in upper-airway of healthy subjects. The selected 9 subjects were proved not to have any sleep-related disorder such as snoring or obstructive sleep apnea through clinical examination, radiological examination, sleep study with a portable recording system. Afterward, the Electron Beam Tomography was performed during the waking and sleeping state of subjects, with their mandible in resting and protruded position. Intravenous injection of Dormicum$^{(R)}$ was used for the induction of sleep. The maximum and minimum cross-sectional areas at each airway level during tidal ventilation were measured and the Collapsibility Index for each level of cross-section was also computed. In a comparison with results under variable conditions, the result was showed that the significant difference between each airway level divided with upper, middle, lower region of upper airway is not observed in the average minimum cross-sectional areas and Collapsibility Index. The significant difference only between in wake and sleep state was observed in the average minimum cross-sectional area at the lower region. Also, in wake state, the significant difference between resting and protrusive position of mandible for the average minimum was also observed in cross-sectional area at middle region. In sleep state, no significant difference between resting and protrusive position of mandible was observed in cross-sectional area and the Collapsibility Index.

저자는 상기도부의 동적변화를 관찰하여 수면시의 협착부위와 그 정도를 확인하며, 하악의 전방이동이 상기도부에 미치는 영향과 부위를 조사하고자 하였으며 총 9명의 건강한 피험자를 대상으로 임상적 검사, 방사선학적 검사 및 간이수면다원검사를 실시하여 코골이 및 수면무호흡증 등의 수면장애가 없음을 확인한다. 각성시 및 수면시, 하악의 안정위 및 전방이동시에서 각각 전자선 단층촬영(EBT)을 시행하여 각 조건하의 구인두의 부위별 최대 최소 단면적 및 허탈지수를 구하였다. 이때 수면의 유도를 위해 Dormicum$^{(R)}$을 정맥투여하였다. 그 결과, 각 조건에 따라 비교하였을때 수면 및 하악 전돌에 따른 상부, 중간부, 하부 상기도간의 최소 단면적 및 허탈지수의 유의한 차이는 없었다. 반면 하악 안정위에서 각성 및 수면상태간의 비교시에 구인두의 하부에서 단면적의 유의성 있는 차이가 관찰되었다. 한편, 각성상태에서 하악 안정시와 전돌시간의 비교시에는 중간부에서 단면적의 유의성 있는 차이과 관찰되며 수면상태에서는 하악 안정시와 전돌시 단면적의 변화율을 나타내는 허탈지수에 있어 유의한 차이는 없었다.

Keywords

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