[An epidemiological survey of snoring disease and OSAHS among 374 truck drivers in Guangzhou, China].

OBJECTIVE: To investigate the prevalence rates of snoring disease and obstructive sleep apnea-hypopnea syndrome (OSAHS) and their risk factors among truck drivers in Guangzhou, China. METHODS: A questionnaire survey was conducted in 374 truck drivers who were selected from 5 logistics companies in Guangzhou by cluster sampling. Those who had potential snoring disease or OSAHS underwent polysomnographic monitoring at night. The obtained data were analyzed to calculate the prevalence rates of snoring disease and OSAHS and determine the risk factors for OSAHS. RESULTS: A total of 335 subjects completely questionnaires, with a response rate of 90%. Among the 335 subjects, 125 (37.3%) had habitual snoring, and 42 (12.5%) had OSAHS according to the diagnostic criterion (apnea-hypopnea index ≥ 5 times/h). The multiple stepwise regression analysis showed that the risk factors for OSAHS were age, alcohol use, family history of snoring, body mass index, and upper airway abnormality. Of the subjects with grade ≥ 2 snoring and OSAHS, 65.4% often felt sleepy when driving during daytime, and 42% had suffered or nearly suffered traffic accidents due to sleepiness when driving. Moreover, 95.5% (320) of the 335 truck drivers did not consider snoring a disease, and 98% did not think traffic accident might be related to snoring. CONCLUSION: The prevalence rates of snoring disease and OSAHS among truck drivers are 37.3% and 12.5%, respectively. Therefore, prevention measures should be established according to the epidemiological characteristics to help the truck drivers realize the hazards of snoring disease and OSAHS, thus minimizing the prevalence and hazards of the diseases.

[Effect of uvulopalatopharyngoplasty on obstructive sleep apnea hypopnea syndrome in patients with resistant hypertension].

OBJECTIVE: To investigate the effect of uvulopalatopharyngoplasty (UPPP) to obstructive sleep apnea hypopnea syndrome (OSAHS) in patients with resistant hypertension (RH). METHODS: UPPP and modified UPPP were performed on 36 moderate and severe OSAHS patients, who also suffered from RH [who taking more than three kinds of antihypertensive drugs (including diuretics) and still not able to control blood pressure at 140/90 mm Hg (1 mm Hg = 0.133 kPa)]. Polysomnography monitoring, ambulatory blood pressure monitoring, apnea hypopnea index (AHI), lowest saturation of blood oxygen (SaO2) and the changes of antihypertensive medication dosage were performed to the patients before and 6 months after the surgery. RESULTS: Six months after surgery,the total efficiency was 61.1% (22/36). The AHI median [25 quartile; 75 quartile] from 37.5 [26.0; 48.3]/h to 9.5 [9.0; 21.3]/h, the lowest the SaO2 average (x(-) ± s, the same below) increased from 0.655 ± 0.114 to 0.860 ± 0.037, the differences were statistically significant (P value < 0.05). 24 h systolic blood pressure, daytime systolic blood pressure, night contraction, diastolic and mean arterial pressure decreased from (160.8 ± 6.8), (170.5 ± 2.5), (163.6 ± 10.5), (100.8 ± 5.6) and (96.8 ± 7.5) mm Hg to (142.5 ± 7.3), (150.8 ± 7.6), (140.1 ± 6.4), (81.8 ± 7.4) and (93.7 ± 2.4) mm Hg, the differences were statistically significant (P < 0.05). The degrees of AHI descent and the average SaO2 improvement were concerned with the degree of systolic blood pressure, diastolic blood pressure decent (r > 0.80 and r(2) > 0.50). The average numbers of antihypertensive drugs decreased form (3.6 ± 0.5) to (2.9 ± 0.5) compared preoperatively and postoperatively, the difference was statistically significant (t = 5.537, P < 0.01). The use of antihypertensive medication reduced in 23 cases (23/36, 63.8%) compared preoperatively and postoperatively. CONCLUSIONS: The blood pressure of the patients with OSAHS and RH dropped significantly after UPPP surgery. Recent follow-up shows that the varieties of antihypertensive drugs taken in these patients are reduced significantly after operation.

The topographical relationships and anastomosis of the nerves in the human internal auditory canal.

INTRODUCTION: The anatomy of the nerves in the human internal auditory canal (IAC) has been reported by a number of authors, and there are some differences among the viewpoints of the literatures. With the development of the microsurgery and endoscopic surgery in the IAC, the study of the topographical relationship of the nerves in the human IAC becomes more and more important. The purpose of this study was to investigate the anastomosis and topographical relationship of the nerves in the human IAC. METHODS: In this study, we dissected 30 human temporal bones from 15 heads, and examined the topographical relationship and the anastomosis of the nerves in human IAC. RESULTS: (1) In 11 out of 30 cases (37%), the facial nerve is anterosuperior to the vestibulocochlear nerve through the whole IAC; and for the remaining 19 cases (63%), the facial nerve rotates anteroinferiorly at an angle ranging from 30 degrees to 90 degrees , which is in the same direction as that of the cochlear. (2) Vestibulofacial nerve anastomosis occurs in 25 cases (83%), of which 67% appears near the porus acusticus, and of which 33% appears between the lateral and intermedial portion of IAC. The diameter was about 0.5-1 mm. (3) Vestibulocochlear anastomosis occurs in 24 cases (80%) among which, some brush-like nerve fiber bundles of the cochlear nerve were seen to enter the acculus proprius directly in 13 cases. Transverse vestibulocochlear anastomosis in the fundus of internal acoustic meatus occurred in 15 cases, including two cases with more anastomosis. No vestibulocochlear nerve anastomosis was found in six cases in this study. CONCLUSIONS: Our study shows that the Vestibulofacial nerve anastomosis and the vestibulocochlear nerve anastomosis do exist, and some variations appear due to individual differences. The appearance of the facial and vestibulocochlearnerves is variable but follows certain consistent patterns.