Department of Otorhinolaryngology, China Medical University Hospital, Taichung 40402, Taiwan.
Department of Otolaryngology, Taipei Medical University Shuang Ho Hospital, Taipei 23561, Taiwan.
Int J Environ Res Public Health. 2020 Aug 19;17(17):6041. doi: 10.3390/ijerph17176041.
The Velum, Oropharynx, Tongue base and Epiglottis (VOTE) classification on drug-induced sleep endoscopy (DISE) is used widely for obstructive sleep apnea (OSA) syndrome, though research into comparative physical examinations with VOTE on DISE is still limited. The aim of this study was to evaluate the relationship between the findings of physical examinations and DISE in patients with OSA. Fifty-five patients with OSA were enrolled in this retrospective study. All of the patients received clinical explorations including a Brodsky classification, a modified Mallampati score (MMS), a modified Friedman's staging system, and a Muller's test. Drug-induced sleep endoscopy was further evaluated in the operating room. There were significant relationships between Brodsky classification, modified Friedman's staging system, Muller's test and oropharynx collapse during DISE ( < 0.05). Brodsky classification, MMS, modified Friedman's staging system and retropalatal lateral-to-lateral (L-L) collapse of Muller's test were significantly correlated with VOTE count ( < 0.05). The concordance between VOTE under DISE and Brodsky classification or modified Friedman's staging system was moderate. In contrast, the concordance between VOTE under DISE and MMS or Muller's test was slight. The study revealed that Brodsky classification and Friedman staging had a significant relationship with DISE on the velum and oropharynx, but the level of tongue base is uncertain between DISE and MMS. Correlation of awake evaluation of tongue base is still not correlated to the DISE findings. Pre-treatment evaluation of DISE is still warranted.
在药物诱导睡眠内镜检查（DISE）中，使用软腭、口咽、舌根和会厌（VOTE）分类广泛用于阻塞性睡眠呼吸暂停（OSA）综合征，尽管关于 VOTE 与 DISE 比较体格检查的研究仍然有限。本研究旨在评估 OSA 患者体格检查与 DISE 结果之间的关系。55 例 OSA 患者纳入本回顾性研究。所有患者均接受临床检查，包括 Brodsky 分类、改良 Mallampati 评分（MMS）、改良 Friedman 分期系统和 Muller 试验。进一步在手术室进行药物诱导睡眠内镜检查。Brodsky 分类、改良 Friedman 分期系统、Muller 试验与 DISE 期间口咽塌陷之间存在显著相关性（<0.05）。Brodsky 分类、MMS、改良 Friedman 分期系统和 Muller 试验的后路横向到横向（L-L）塌陷与 VOTE 计数显著相关（<0.05）。DISE 下的 VOTE 与 Brodsky 分类或改良 Friedman 分期系统之间的一致性为中度。相比之下，DISE 下的 VOTE 与 MMS 或 Muller 试验之间的一致性为轻度。研究表明，Brodsky 分类和 Friedman 分期与 DISE 下的软腭和口咽有显著关系，但 DISE 与 MMS 之间的舌根水平不确定。清醒时评估舌根的相关性仍然与 DISE 结果无关。仍需要进行 DISE 的治疗前评估。
