Huang X X, Chen H H, Tang J, Lu J, Deng Y Q, Li X P
Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Jun 20;31(12):918-924. doi: 10.13201/j.issn.1001-1781.2017.12.006.
To compare the differences of the sites of airway obstruction in OSAHS patients between awake and sleep state by using the VOTE classification system. Forty OSAHS patients diagnosed by PSG underwent awake Müller's maneuver and drug-induced sleep endoscopy (DISE). Video and compare the observation. Its findings were described using the VOTE classification system which include the following features: level, degree and configuration of obstruction. Associations were analyzed between different degrees of obstruction, BMI, AHI, minimal SaO₂ and average SaO₂. Our patients had 52.5% complete velum collapse and 30.0% complete oropharyngeal lateral wall collapse in awake Müller's maneuver. In DISE, airway closure of 95.0% cases related to velum occurred collapse in concentric configuration, and 90.0% cases showed completely obstructive. We found that 60.0% complete oropharyngeal lateral wall collapse and 17.5% complete tongue base collapse. There was a significant difference in the VOTE scores between DISE and awake Müller's maneuver, and the VOTE scores of DISE were higher in all levels (<0.05). No association was found between degrees of obstruction, AHI, BMI, minimal SaO2 and average SaO₂ in Müller's maneuver (>0.05). Complete velum collapse was just significantly associated with AHI and minimal SaO₂ in DISE (<0.05). The VOTE scores of DISE were higher than awake Müller's maneuver, reflected by more obstructive levels and severe degree. The difference between different degrees of obstruction, BMI, AHI, minimal SaO₂ and average SaO₂ was not significant.
运用VOTE分类系统比较阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者清醒和睡眠状态下气道阻塞部位的差异。40例经多导睡眠监测（PSG）确诊的OSAHS患者接受了清醒状态下的米勒动作及药物诱导睡眠内镜检查（DISE）。对视频进行观察并比较。采用VOTE分类系统描述其结果，该系统包括以下特征：阻塞水平、程度和形态。分析不同程度阻塞与体重指数（BMI）、呼吸暂停低通气指数（AHI）、最低血氧饱和度（SaO₂）及平均血氧饱和度之间的相关性。在清醒米勒动作中，我们的患者有52.5%软腭完全塌陷，30.0%口咽侧壁完全塌陷。在DISE中，95.0%与软腭相关的气道关闭呈同心形态塌陷，90.0%表现为完全阻塞。我们发现60.0%口咽侧壁完全塌陷，17.5%舌根完全塌陷。DISE和清醒米勒动作的VOTE评分存在显著差异，DISE在所有水平的VOTE评分均更高（<0.05）。在米勒动作中，未发现阻塞程度、AHI、BMI、最低SaO₂和平均SaO₂之间存在相关性（>0.05）。在DISE中，软腭完全塌陷仅与AHI和最低SaO₂显著相关（<0.05）。DISE的VOTE评分高于清醒米勒动作，表现为阻塞水平更多、程度更严重。不同程度阻塞、BMI、AHI、最低SaO₂和平均SaO₂之间的差异不显著。
