Localization of site of obstruction in snorers and patients with obstructive sleep apnea syndrome: a comparison of fiberoptic nasopharyngoscopy and pressure measurements.

The site of obstruction in the upper aerodigestive tract in 20 snorers and/or patients with obstructive sleep apnea syndrome was determined by two methods: fiberoptic nasopharyngoscopy with the Müller manoeuvre and continuous, nocturnal pressure measurements in the upper aerodigestive tract supplemented with recording of O2 saturation and oro-nasal air-flow. Identical results were obtained by both methods in only 5 (25%) of the patients, whilst in 11 (55%) obstruction was recorded in the pharynx by the pressure method which could not be demonstrated by the Müller manoeuvre. The latter method is not sufficiently accurate and should no longer be used in the pre-treatment assessment of this group of patients. Measurement of pharyngeal pressure, O2 saturation and air-flow are recommended in the diagnostic work-up.