[Assessment of dysphagia: report of 37 cases].

OBJECTIVE: To explore the assessment methods of dysphagia. METHODS: The data of 37 patients with dysphagia were retrospectively analyzed. These patients took the Kubota drinking test, Tengdao's evaluation, videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES). RESULTS: Fourteen out of thirty-seventh patients showed abnormal results during Kubota drinking test. Tengdao's evaluation results showed that 29/37 patients were abnormal. There 27/37 and 33/37 patients showed abnormalities in positive-aspiration score and swallow dysfunction score of VFSS. The number of abnormal patients in aspiration score of FEES was 19/21. The Kappa values were 0.137, 0.416 between Kubota drinking test. Tengdao's evaluation and VFSS. The FEES was measured against the VFSS for sensibility, specificity, positive predictive value, and negative predictive value, the values were 88.9%, 66.7%, 94.1% and 50.0%. CONCLUSIONS: Kubota drinking test and Tengdao's evaluation can be applied for screening purpose and evaluating result after treatment; VFSS and FEES can be used as more accurate assessments, they can study the dysphagia's character, position and severity. The combination of a variety of dysphagia evaluation methods is the most important basis for diagnosis and treatment of deglutition disorders.

[A simplified Chinese version of the Quebec sleep questionnaire was evaluated for reliability and validity].

OBJECTIVE: To develop a simplified Chinese version of the 32-item Quebec sleep questionnaire (QSQ) and to examine the reliability and validity. METHODS: A cross-sectional sample of 141 patients [22 simple snorers and 119 obstructive sleep apnea hypopnea syndrome (OSAHS)] and a longitudinal sample of 55 patients [35 in uvulopalatopharyngoplasty (UPPP) group and 20 in control group] completed the simplified Chinese version of QSQ for assessment of its feasibility, reliability, validity and responsiveness. RESULTS: QSQ had good feasibility. All internal consistency coefficients exceeded 0.65. Intraclass correlation coefficients of five domains for test-retest reliability ranged from 0.82 - 0.91. There were significant differences in four domains (daytime sleepiness, diurnal symptoms, nocturnal symptoms and social interactions) among patients with different severity of apnea hypopnea index (AHI) and lowest saturation of arterial oxygen (LSaO2, P < 0.01 or < 0.05). Correlations between QSQ scores and five domains and Epworth sleepiness scale (ESS) were statistically significant (P < 0.01). Correlations between QSQ scores and three domains (daytime sleepiness, nocturnal symptoms and social interactions) and polysomnography (PSG) indices (AHI and LSaO2) were statistically significant (P < 0.05). There were significant differences in scores of five domains of patients between at baseline and after UPPP. There were significant differences in change scores of five domains between patients who were treated and those who were not. CONCLUSION: The simplified Chinese version of QSQ offers good reliability, validity and responsiveness and can be used as a OSAHS-specific instrument to assess impact of illness and treatment effectiveness in OSAHS patients.

[One night treatment of obstructive sleep apnea and hypopnea syndrome with nasopharyngeal airway].

OBJECTIVE: To investigate the therapeutical effect and feasibility of treating obstructive sleep apnea hypopnea syndrome (OSAHS) with nasopharyngeal airway. METHODS: Thirty-two OSAHS patients were treated with silicone nasopharyngeal airway for one night. Each patient had Somite polysomnography (PSG) for the first night and repeated PSG with the nasopharyngeal airway treatment for the second night. PSG parameters were compared between the two nights. With normal distribution data in (x(-) +/- s), Paired-Samples t test was used. RESULTS: Overall patient tolerance of the nasopharyngeal airway for one night was 90.6% (29/32). With the nasopharyngeal airway treatment, the AHI of the 29 patients decreased from (44.7 +/- 16.0)/h to (14.6 +/- 10.0)/h, the longest time of apnea shortened from (44.3 +/- 11.5) s to (30.1 +/- 13.2) s, the lowest arterial oxygen saturation increased from (0.722 +/- 0.080) to (0.861 +/- 0.070) and the percentage of sleep time with arterial oxygen saturation < 0.90 decreased from (19.2 +/- 18.0)% to (1.5 +/- 4.0)%. Data showed obvious therapeutical effect (Paired-Samples t test, P < 0.001). The subject symptoms of the 29 patients improved obviously that night with treatment and the following day after treatment. The therapeutical successful rate for one night was 65.5% (19/29, a reduction of AHI by 50% and AHI < 20/h). The noneffective reason of the six patients was probably that they had higher proportion of tongue base obstruction. CONCLUSIONS: The single-night preliminary experiment shows that the treatment using nasopharyngeal airway has obvious therapeutical effect for OSAHS patients with retropalatal obstruction and provides clinical evidence for developing a new treatment approach in the future. In addition, based on the result of nasopharyngeal airway treatment, the obstruction level may be evaluated.