Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Laryngoscope. 2021 Feb;131(2):E659-E664. doi: 10.1002/lary.28774. Epub 2020 May 30.
OBJECTIVES/HYPOTHESIS: This study aimed to assess the role of capnography in objectively evaluating breathing routes during drug-induced sleep endoscopy (DISE) and further elucidate the relationship between breathing route, obstructive sleep apnea (OSA) severity, and DISE findings.
Prospective observational study.
Nighty-five patients with established OSA were recruited for this study from May 2017 to May 2019. DISE was performed in the operating room. Sedation was maintained with propofol using a target-controlled infusion system and the depth of sedation was monitored based on the bispectral index. The breathing routes, which included oral breathing, oronasal breathing, and nasal breathing, were detected using capnography. DISE findings were recorded using the VOTE (velum, oropharynx, base of tongue, and epiglottis) classification.
Patients with mouth breathing were associated with increased OSA severity, worse oximetric variables, and higher body mass index in comparison with those with other breathing routes. Mouth breathing was associated with a higher degree and higher prevalence of lateral pharyngeal wall collapse and tongue base collapse during DISE.
Mouth breathing was significantly associated with worse oxygen desaturation and increased degree of upper airway collapse. Therefore, patients with mouth breathing during propofol-based intravenous anesthesia should be carefully monitored.
4 Laryngoscope, 131:E659-E664, 2021.
目的/假设：本研究旨在评估二氧化碳描记术在药物诱导睡眠内镜检查（DISE）中客观评估呼吸途径的作用，并进一步阐明呼吸途径、阻塞性睡眠呼吸暂停（OSA）严重程度和 DISE 结果之间的关系。
前瞻性观察性研究。
从 2017 年 5 月至 2019 年 5 月，本研究招募了 95 例确诊 OSA 的患者。在手术室进行 DISE。使用靶控输注系统以丙泊酚维持镇静，并根据双频谱指数监测镇静深度。使用二氧化碳描记术检测呼吸途径，包括口腔呼吸、口鼻呼吸和鼻呼吸。使用 VOTE（软腭、口咽、舌根和会厌）分类记录 DISE 结果。
与其他呼吸途径相比，张口呼吸的患者与 OSA 严重程度增加、血氧计变量更差和体重指数更高相关。张口呼吸与 DISE 期间更严重和更高比例的侧咽壁塌陷和舌根塌陷相关。
张口呼吸与更严重的氧饱和度下降和上呼吸道塌陷程度增加显著相关。因此，在基于丙泊酚的静脉麻醉期间张口呼吸的患者应密切监测。
4《喉镜》，131：E659-E664，2021 年。
