ALTERACIONES ANATÓMICAS DE LA NASO-OROFARINGE COMO ETIOLOGÍA DE LA APNEA DEL SUEÑO: UNA REVISIÓN DE LA FISIOPATOLOGÍA Y MÉTODOS QUIRÚRGICOS DEL SÍNDROME
DOI:
https://doi.org/10.47820/recima21.v4i4.2999Palabras clave:
anatomia, Cirurgías, fisiopatologia, apnea, NasofaringeResumen
El Síndrome de Apnea Obstructiva del Sueño se caracteriza por un trastorno respiratorio del sueño, con episodios recurrentes de obstrucción parcial o total de las vías respiratorias superiores. El sobrepeso, la obesidad y el sexo masculino son algunos de los factores de riesgo más extendidos para la AOS. Aunque son factores sumamente importantes, es necesario dar más espacio y notoriedad a otros factores: los anatómicos. La faringe se divide en tres segmentos: nasofaringe; orofaringe, que conduce el aire una vez inhalado; y laringofaringe, responsable de bloquear el paso al esófago cuando se inhala aire. Algunas alteraciones craneofaciales (específicamente en la oronasofaringe) las presentan varios individuos con AOS. Las personas con mayor resistencia al flujo de aire en los segmentos fijos y mayor flacidez del segmento flexible están más predispuestos al colapso de las vías respiratorias superiores, que es un factor de riesgo principal para el desarrollo de AOS, independientemente de la obesidad, la circunferencia del cuello y otras anomalías craneofaciales. El tratamiento quirúrgico está indicado como terapia primaria para la AOS cuando una obstrucción fija corregible quirúrgicamente de las vías respiratorias es responsable de la apnea. En las últimas décadas, ha habido un aumento en los avances de la tecnología quirúrgica, pero se necesita más investigación para cuantificar mejor los cambios en los resultados centrados en el paciente, así como los resultados cardíacos, metabólicos, neurocognitivos y de mortalidad a largo plazo
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