Amali Amin, Erfanian Reza, Amirzargar Behrooz, Sadeghi Mohammad, Saedi Babak, Emami Hamed, Heidari Reihaneh, Mirashrafi Fatemeh, Golparvaran Saeed
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Otorhinolaryngology-Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):2769-2776. doi: 10.1007/s12070-023-03871-6. Epub 2023 May 13.
To investigate associations between polysomnographic findings and the severity of upper airway obstructions during Muller's Maneuver (MM) and Drug-Induced Sleep Endoscopy (DISE) in patients with obstructive sleep apnea syndrome (OSAS).
This was a prospective cohort study. Adult patients newly diagnosed with OSAS in a tertiary sleep center were included consecutively and evaluated by polysomnography and MM. They then underwent DISE in an operating room. The associations between polysomnographic findings and the severity of upper airway obstructions during MM and DISE were assessed. Also, the degree and pattern of obstructions were compared using a modified VOTE questionnaire.
145 patients (mean age 41.5 ± 10.1 years) were enrolled. There were no associations between Respiratory Disturbance Index (RDI), mean and lowest O saturation, and body mass index on the one hand, and obstruction degree in MM and DISE (p > 0.05). However, a significant positive correlation was observed between RDI and total VOTE scores in DISE and MM (r = 0.179, p = 0.031 and r = 0.221, p = 0.008 respectively). There were no differences between MM and DISE in diagnosing the degree of obstruction in the velum area (p = 0.687) and the epiglottis (p = 0.50). However, a significant difference was observed between the two techniques in the oropharynx lateral wall (p < 0.001) and tongue base (p = 0.017).
Although there was no association between polysomnographic findings and the severity of obstruction in MM and DISE for the separate levels of the upper airway, obstruction severity may be assessed more accurately by total VOTE score, which is representative of RDI severity.
探讨阻塞性睡眠呼吸暂停综合征（OSAS）患者在米勒动作（MM）和药物诱导睡眠内镜检查（DISE）期间多导睡眠图结果与上气道阻塞严重程度之间的关联。
这是一项前瞻性队列研究。连续纳入在三级睡眠中心新诊断为OSAS的成年患者，并通过多导睡眠图和MM进行评估。然后他们在手术室接受DISE。评估多导睡眠图结果与MM和DISE期间上气道阻塞严重程度之间的关联。此外，使用改良的VOTE问卷比较阻塞的程度和模式。
共纳入145例患者（平均年龄41.5±10.1岁）。呼吸紊乱指数（RDI）、平均和最低血氧饱和度以及体重指数与MM和DISE中的阻塞程度之间均无关联（p>0.05）。然而，观察到RDI与DISE和MM中的总VOTE评分之间存在显著正相关（分别为r = 0.179，p = 0.031和r = 0.221，p = 0.008）。MM和DISE在诊断软腭区域（p = 0.687）和声门（p = 0.50）的阻塞程度方面没有差异。然而，两种技术在口咽侧壁（p<0.001）和舌根（p = 0.017）方面存在显著差异。
尽管对于上气道的不同水平，多导睡眠图结果与MM和DISE中的阻塞严重程度之间没有关联，但阻塞严重程度可能通过代表RDI严重程度的总VOTE评分更准确地评估。
