Computed tomography of the maxillofacial area with preliminary contrast in planning of surgical treatment of rhonchopathy

Ryabova M.A.

Pavlov First Saint Petersburg State Medical University

ORCID: 0000-0002-6714-9454

Karpishchenko S.A.

Pavlov First Saint Petersburg State Medical University

ORCID: 0000-0003-1124-1937

Zubareva A.A.

Pavlov First Saint Petersburg State Medical University

ORCID: 0000-0003-1567-4860

Faizova A.R.

Pavlov First Saint Petersburg State Medical University

ORCID: 0000-0001-5463-7830

Computed tomography of the maxillofacial area with preliminary contrast in planning of surgical treatment of rhonchopathy

Authors:

Ryabova M.A., Karpishchenko S.A., Zubareva A.A., Faizova A.R.

More about the authors

Journal: Russian Rhinology. 2024;32(3): 202‑209

DOI: 10.17116/rosrino202432031202

Downloaded: 1

Contact the author

Table of contents

To cite this article:

Ryabova MA, Karpishchenko SA, Zubareva AA, Faizova AR. Computed tomography of the maxillofacial area with preliminary contrast in planning of surgical treatment of rhonchopathy. Russian Rhinology. 2024;32(3):202‑209. (In Russ.)
https://doi.org/10.17116/rosrino202432031202

Close metadata

OBJECTIVE

To assess the possibility of using computed tomography of the maxillofacial area with preliminary contrast of soft-tissue structures of the throat in the diagnosis and planning of surgical treatment of rhonchopathy.

PATIENTS AND METHODS

A number of patients equal 181 with complaints of snore were examined. All patients included in the study underwent history taking, examination of ENT-organs; sleep evaluation (cardiorespiratory monitoring/stationary polysomnography); determination of body mass index; computed tomography of the maxillofacial area with contrast of soft palate, as a result of which length, thickness of soft palate, palatine uvula. Patients of the 1st group were treated with nonresective laser-assisted uvulopalatoplasty (LAUPP) by method of a contact pinpoint laser exposure. Patients of the 2nd group were treated with nonresective LAUPP by method of interstitial laser exposure on soft palate, pillars of the fauces.

RESULTS

The groups were comparable in age, male sex dominated. In the 1st study group the mean volume of snore decreased from 51.6 to 35.8 dB after LAUPP, the length of the soft palate+the length of the palatine uvula after nonresective LAUPP by method of a contact pinpoint laser exposure decreased by 4 mm (from 38.8 to 34.5 mm), thus the thickness — from 7.7 to 6.4 mm (p<0.05). It has been found that the relative difference of the average proportion of snore was more than 30% (absolute — 16.7 dB (p<0.05)) when comparing the results of the acoustic analysis of snore in the 2nd group. The length of the soft palate+the length of the palatine uvula statistically significantly decreased after 1.5 months after interstitial LAUPP — on average by 10% (4.6 mm), and thickness — by 16.1% (1.5 mm). A strong correlation between the reduction of the length of the soft palate+the palatine uvula and satisfaction with the results of treatment after 1.5 months (r=0.608) has been observed, as well as a statistically significant relationship between the reduction in the length, thickness of the soft palate and the decrease in the volume, duration of snore has been found.

CONCLUSION

Computed tomography of the maxillofacial area with preliminary contrast of soft-tissue structures of the throat allows not only to exclude the presence of pathology from the side of the paranasal sinuses, dentofacial system, but also to identify possible anatomical structures involved in the formation of the acoustical phenomenon of snore, and to assess the risk of obstructive sleep apnoea syndrome presence.

Keywords:

rhonchopathy

surgical methods of snore treatment

computed tomography of the maxillofacial area with preliminary contrast

Authors:

Ryabova M.A.

Pavlov First Saint Petersburg State Medical University

ORCID: 0000-0002-6714-9454

Karpishchenko S.A.

Pavlov First Saint Petersburg State Medical University

ORCID: 0000-0003-1124-1937

Zubareva A.A.

Pavlov First Saint Petersburg State Medical University

ORCID: 0000-0003-1567-4860

Faizova A.R.

Pavlov First Saint Petersburg State Medical University

ORCID: 0000-0001-5463-7830

Received:

26.01.2024

Accepted:

25.03.2024

List of references:

Komarov MV, Potapova PD. Diagnostika i lechenie sindroma obstruktivnogo apnoe` sna v otorinolaringologii. RMZh. Medicinskoe obozrenie. 2019;2(II):59-62. (In Russ.).
Alekseenko SI, Karpishhenko SA, Arustamyan IG, Stancheva OA. Rezul`taty` lecheniya ronxopatii i sindroma obstruktivnogo apnoe` sna u detej s gipertrofiej adenoidny`x vegetacij. Consilium Medicum. 2021;23(3):222-225. (In Russ.).
Akashiba T, Inoue Y, Uchimura N, Ohi M, Kasai T, Kawana F, Sakurai S, Takegami M, Tachikawa R, Tanigawa T, Chiba S, Chin K, Tsuiki S, Tonogi M, Nakamura H, Nakayama T, Narui K, Yagi T, Yamauchi M, Yamashiro Y, Yoshida M, Oga T, Tomita Y, Hamada S, Murase K, Mori H, Wada H, Uchiyama M, Ogawa H, Sato K, Nakata S, Mishima K, Momomura SI. Sleep apnea syndrome (SAS) clinical practice guidelines 2020. Respir Investig. 2022;60(1):3-32. https://doi.org/10.1016/j.resinv.2021.08.010
Karpishhenko S, Aleksandrov A, Sopko O. Rol` sostoyaniya polosti nosa i okolonosovy`x pazux v razvitii rasstrojstv dy`xaniya vo sne. Vrach. 2012;2:28-28. (In Russ.).
Ryabova MA, Faizova AR. Vozmozhnost` zapodozrit` soas srednej i tyazheloj stepeni u pacientov s ronxopatiej v praktike vracha-otorinolaringologa. Folia otorhinolaryngologiae et pathologiae respiratoriae. 2022;28(1):48-55. (In Russ.).
Kozulina MA, Piskunov GZ, Perich BB. Xrap i sindrom obstruktivnogo apnoe` sna u pacientov s xronicheskimi vospalitel`ny`mi zabolevaniyami nosa i okolonosovy`x pazux. Russian Rhinology. 2014;22(4):23-25. (In Russ.).
Bloczkij AA. Opy`t xirurgicheskogo lecheniya pacientov s fenomenom xrapa i sindromom obstruktivnogo sonnogo apnoe`. Rossijskaya rinologiya. 2014;22(2):46-47. (In Russ.).
Dzhafarova MZ, Daĭkhes NA, Averbukh VM, Melnikov AYu. Surgical treatment of snoring, mild and moderate OSA: evolution of methods. Russian Rhinology. 2018;26(4):26-30. (In Russ.). https://doi.org/10.17116/rosrino20182604126
Savoldi F, Xinyue G, McGrath CP, Yang Y, Chow SC, Tsoi JKH, Gu M. Reliability of lateral cephalometric radiographs in the assessment of the upper airway in children: A retrospective study. Angle Orthod. 2020;90(1):47-55.
Chauhan A, Autar R, Pradhan KL, Yadav V. Comparison of pharyngeal airway dimension, tongue and hyoid bone position based on ANB angle. Natl J Maxillofac Surg. 2015;6(1):42-51.
Vizzotto MB, Liedke GS, Delamare EL, Silveira HD, Dutra V, Silveira HE. A comparative study of lateral cephalograms and cone-beam computed tomographic images in upper airway assessment. European Journal of Orthodontics. 2012;34(3):390-393.
Sears CR, Miller AJ, Chang MK, Huang JC, Lee JS. Comparison of pharyngeal airway changes on plain radiography and cone-beam computed tomography after orthognathic surgery. J Oral Maxillofac Surg. 2011;69(11):e385-394.
Faizova AR, Ryabova MA, Zubareva AA, Karpishhenko SA. Patent RF No. 2 800 304 ot 20.07.2023 «Metodika kontrastirovaniya myagkogo neba pered provedeniem luchevoj diagnostiki s posleduyushhej morfometriej». (In Russ.).
Butorova EA, Shariya MA, Litvin AYu, Ustyuzhanin DV. Magnitno-rezonansnaya tomografiya v ocenke anatomicheskix struktur verxnix dy`xatel`ny`x putej u pacientov s ozhireniem i raznoj stepen`yu techeniya sindroma obstruktivnogo apnoe` sna. REJR. 2015;5(4):33-40. (In Russ.).
Shariya MA, Butorova EA, Litvin AYu, Ustyuzhanin DV, Elfimova EM, Gorieva ShB, Ternovoy SK, Chazova IE. Magnetic resonance tomography in sleep apnea syndrome diagnostics. Cardiovascular Therapy and Prevention. 2015;14(2):58-61. (In Russ.).
Shapiro SS, Wilk MB. An analysis of variance test for normality (complete samples). Biometrika. 1965;52(3):591-611.

Close metadata