Анатомо-морфологические особенности строения мягкого нёба у пациентов с храпом и синдромом обструктивного апноэ сна

Abstract

The study involved 73 patients with snoring and sleep apnea, aged 25 to 74 years, who underwent reconstructive interventions on the soft palate as a surgical treatment. As part of the preoperative examination, all patients underwent night respiratory monitoring in order to identify and assess the severity of respiratory disorders during sleep. A histological analysis of all tissues removed during the operation and a comparison of the identified changes with the visual picture during a pharyngoscopic examination were carried out. Depending on the pharyngoscopy, 5 main types of soft palate were identified, on the basis of which the patients were divided into 5 groups. The mildest clinical manifestations of obstructive sleep apnea (OSA) were noted in patients from groups 1 and 2, and the most severe, in patients from group 4. Morphological changes were represented by reactive phenomena of the mucous membrane, stromal edema, transformation of the mucous glands, an increase in the vascular component, and the development of chronic inflammation. Analyzing the results obtained, a relationship was noted between the severity of OSA and the morphological features of the removed palatine uvula. It can be assumed that 5 types of soft palate are the stages of one pathophysiological process successively replacing one another.