Immunohistochemical and histomorphometric study of human uvula innervation: a comparative analysis of non-snorers versus apneic snorers
| Autor: | Guglielmo Nicoletti, Fabio Pagni, Claudio Vicini, Mauro De Bellis, Sonia Gorla, Susanna Ronchi, Camillo Di Bella, Giuseppe Limonta, Monica Cucci |
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| Přispěvatelé: | De Bellis, M, Pagni, F, Ronchi, S, Limonta, G, Gorla, S, Nicoletti, G, Cucci, M, Di Bella, C, Vicini, C |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Sleep Apnea Palatopharyngeus muscle Biopsy Polysomnography medicine.medical_treatment Neural deficit Snorers Uvulas Aged Body Mass Index Female Humans Middle Aged Nerve Fibers Pharyngeal Muscles Reference Values Sleep Apnea Obstructive Snoring Uvula Young Adult Otorhinolaryngology2734 Pathology and Forensic Medicine Neurology (clinical) Medicine (all) Motor nerve Economica Ptosis Head and neck pasthology Medicine medicine.diagnostic_test Obstructive business.industry Uvulopalatopharyngoplasty medicine.disease Surgery Obstructive sleep apnea Otorhinolaryngology Inclusion and exclusion criteria medicine.symptom business |
| Zdroj: | Sleep and Breathing. 16:1033-1040 |
| ISSN: | 1522-1709 1520-9512 |
| DOI: | 10.1007/s11325-011-0597-7 |
| Popis: | Objective: The objective of this study was to verify a possible correlation between the etiology of uvulopalatal ptosis and decrease in palatopharyngeal muscle tone, due to a reduction of the number of nerve fibers in surgical specimens obtained from snoring patients. Design/setting of the study: We have designed a comparative retrospective, case-control, double-blind, immunohistochemical and histomorphometric study of human uvula innervation in 51 apneic snoring patients who underwent uvulopalatopharyngoplasty (UPPP) and 47 normal subjects collected in a 5-year-long period in the Departments of Otolaryngology of Desio and Forlì Hospital, Italy. Patients: Case study was chosen in patients who underwent UPPP, variably associated with other disobstructive surgical procedures for treatment of obstructive sleep apnea syndrome, classified according to current clinical, polysomnographic, endoscopic, and imaging criteria. Control subjects were recruited at the Institute of Legal Medicine, University of Milan, according to strong inclusion and exclusion criteria. The main outcome measure of the study was the number of nerve fibers in the patients' uvula evaluated histologically and repeated two times by two different people, in all the areas of the specimens. Finally, we correlated the area of the histological section with the number of fibers contained therein. Results: The number of nerve fibers varied from a minimum of 58 to a maximum of 163 in normal subjects. In the snoring patient population, the number of nerve fibers varied from a minimum of 22 to a maximum of 126 (statistically significant difference, p < 0.0001). In conclusion, our results direct toward a clear neurogenetic predisposition to uvulopalatal ptosis, marked ab initio by a lower set of motor nerve fibers, which may be the initial stage of another subsequent morphological and functional abnormality. © 2011 Springer-Verlag. |
| Databáze: | OpenAIRE |
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