[Comparison of methods in determining the obstructive sites of obstructive sleep apnea-hypopnea syndrome: flexible pharyngoscopy vs upper airway pressure measurements].

OBJECTIVE

To compare the two methods, flexible pharyngoscopy with Müller's maneuver (FPMM) and continuous upper airway pressure measurements (UAPM), in determining the sites of obstruction in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).

METHOD

Thirty-six patients with OSAHS underwent both FPMM and continuous upper airway pressure measurement to determine the sites of obstruction. Different criteria were adopted for retropalatal obstruction and retroglossal obstruction determined by FPMM.

RESULT

When reduction of cross section area > or = 75% was considered as obstruction by FPMM, the identical results obtained by both methods were in 27 of 36 (75%) patients and kappa value was 0.138 in retropalatal region, the identical results were in 19 of 36 patients (53%) patients and kappa value was 0.121 in retroglossal region. When reduction of cross section area > or = 90% were considered as retropalatal obstruction, the identical results were in 30 of 36 (83%) and kappa value was 0.526. When reduction of cross section area > or = 50% were considered as retroglossal obstruction, the identical results were in 25 of 36 (69%) patients and kappa value was 0.389.

CONCLUSION

Coincidence of FPMM and UAPM in determination of obstructive site was higher in retropalatal region than in retroglossal region. More stringent criterion for retropalatal obstruction and looser criterion for retroglossal obstruction by FPMM may help to increase the coincidence of the two methods in both regions.