The Study Of The Construction Of OSAHS Animal Model And Pathology Of The Palatopharyngeal Tensor Muscles Of OSAHS Animal Model And The Surgical Study Of OSAHS

Objective To set up a reliable and dependable animal model is the precondition and instrument to study this disease. Now the research about obstructive sleep apnea—hypopnea syndrome (OSAHS)is still on the beginning,because pathogeny,pathology and pathophysiology are so complexed that construct a perfect model is difficult. Genioglossus muscle is the most powerful muscle of all the palatopharyngeal tensor muscles. When genioglossus is relaxed, the body of the tongue will be drop backwards to obstruct the upper airway and this is the main cause of OSAHS. Botulinum toxin is such a drug who can cause muscle laxation for a long time, and without any complication in the safe dosage. So we have such a presumption to construct the OSAHS model—injecting Botulinum toxin to genioglossus to cause the tongue fall backwars,then the space post the root of the tongue will change to stricture or closed. The objection to set up this animal model :the first is to provide an instrument for other one to research OSAHS,then make the base for our the second study—the continuous pathological changes of the soft palate in the OSAHS model obstructive post the root of the tongue.Now it is definite that there are anatomy stricture in all the patients of OSAHS, and the position of the structure are mainly at the plate of soft palate or at the plate of the root of tongue. We have found there is only one plate happened structure in most mild patients while both of two plates have structure in all heavy patients. We all know any organs and systems have the function of compensation when at the beginning of the diseases,but if therapy hasnot been done at this time, excessive compensation will lead to real disease,for example simple goiter can develope to nodular goiter even hyperthyroidism; hypertension can lead to left cardiac ventricle to failure et al. we nature to think in the progress of OSAHS when one plate of the upper airway occurs structure then another plate's tensor m.will be construct strengthly to enlarge the size of the upper airway to increase ventilation capability, but the muscle will developed strain and laxation if having not any therapy. And the muscles relaxtion of the second plate will make this position to structure and decrease the ventilation capability, then the disease developed seriously. We want to research this question to continuously observe the soft palate histological change of the OSAHS model we make in the first part of our experiment.As a plastic surgeon, we realize OSAHS and the cleft palate belong commonly to palatopharyngeal closed diseases, but OSAHS is the ventilation closed excessively and the cleft palte is the ventilation cannot closed entirely. Recording the principal of pastic surgery, the cleft palate is the tissue decrease and displace; and OSAHS is the tissue increase and displace, our operation is do a rhombus shape excision of the soft palate to therapy obstructive sleep apnea-hypopnea syndrome .Methods is resect of partial tissue in rhombus shape in the middle of soft palate and suture in transverse to lift soft palate to enlarge pharyngeal cavity, while without resecting the uvula. And we do a follow-up of 6 monthes at least.Methods 1. we selected 28 the New Zealand White rabbits as experimental animals and were randomly classified into three groups ,one is trial group and two are control groups. We injct Botulinum toxin to Genioglossus as to trial group animals and inject equal volume normal sodium(NS) to one control group and inject equal volume BTX(Botulinum toxin ) to biceps femoris to other control group. We do continuous monitoring of all animals of SaO₂(arterial oxygen saturation) and compute the times of ODI₄(oxygen desaturation index four) .we do the results a student test and the standar of the successful animol model is P<0.05; 2. We selected 40 the New Zealand White rabbits and classified into 5 groups randomly and it is 8 animals in every group after we had maken OSAHS animal model successfully. The conrol group havenot any disposition and inject BTX to Genioglossus to another groups .then we put one the trial group to death and cut the sofe palate muscle to do a study of pathology every 10 days. We observe the histologcal changes through the light microscope and the electron microscope and do succinate dehydrogenase(SDH) staining with Nachlase and do a gray grade analyses .3. Recording the principal of the plastic surgery "just resect the tissue that is spare" and the degree of the relaxed soft palate ,we choiced 13 OSAHS patients just with the obstruction lied on the area of oropharynx and do a resection of partial tissue in rhombus shape in the middle of soft palate and suture in transverse to lift soft palate to enlarge pharyngeal cavity, while without resecting the uvula.Results 1 .the animals were found the signs of hypoxia,cyanosis on the nose ,lips and the edge of ears.they have intermit SaO2 decreasing,and the significant differences exsisted between the trial group and two contral groups(P<0.05); 2.the colour of succinate dehydrogenase(SDH) staining has changed deeply on the trial group on 20days afterwe inject BTX to Genioglossus,and the construct of mitochondria is normal, myofilament change thicker. But succinate dehydrogenase(SDH) staining has changed lighter , myofilament change decreased and atrophia and crista of mitochondria reduced;3.we treated 13 OSAHS patients with A rhombus shape excision of the soft palate, we have done a follow-up of 6 monthes at least,and they all had an effective treatments and without serious complications,and the founction of kinesis of the soft palate is well.Conclusions With the method of injecting BTX to rabbits' Genilglossus we can set up OSAHS animal model successfully and this kind of model is more to approach etiopathogenisis and pathology of the mankind. The palatopharyngeal tensor muscle has the compensation when one plate of the upper airway occurs stricture , but if therapy hasnot been done at this time, excessive compensation will lead to laxation and the muscles relaxtion of the second plate will make disease developed seriously. It is a vacious cycle. So it is necessary for OSAHS patients to see a doctor at the beginning of the initial stage of the disease. A rhombus shape excision of the soft palate had an effective treatments for OSAHS and without serious complications...