Comparison of sleep MRI and sleep endoscopy findings in patients with obstructive sleep apnea syndrome

Abstract

OBJECTIVE: In this study we aimed to compare the findings of  two methods which developed for the diagnosis of obstructive pathology in patients with obstructive sleep apnea syndrome (OSAS); sleep endoscopy and dynamic sleep magnetic resonance imaging (MRI) .

METHODS: A total of 20 patients with OSAS (AHI> 5) were included in the study. Anteroposterior (A-P) diameter and surface area measurements of uvulopalatal region, retropalatal region and tongue root were performed by MRI in sleep and wakefulness. The mean measurement of sleep and wakefulness were compared. In these patients, sleep endoscopy (UE) was performed under operating room conditions. The correlation of the obtained data was evaluated by statistical methods.

RESULTS: There was a statistically significant decrease in sleep MRI evaluation in all three regions compared to measurements in awake position (p <0.001). The mean diameter and surface area of the patients with UE occured at 50% or more at the level of uvulopalatal and tongue root were statistically significantly lower than those with less than 50% obstruction (p <0.05). Therefore, UE and Sleep MRI data were interpreted as compatible with each other (p <0.05).

CONCLUSION: Similarity of UE findings with sleep MRI findings, which is a more objective technique, is important in terms of showing the effectiveness of UE. In addition, the UE is more advantageous in that it can be applied with less equipment and allows direct visualization of the pre-operative occlusion site.

Keywords

• Sleep apnea,snoring,sleep endoscopy,MRI,polysomnography

Tıkayıcı Uyku Apne Sendromlu Olgularda Uyku MRG Ve Uyku Endoskopisi Bulgularının Karşılaştırılması

Abstract

AMAÇ: Çalışmamızın amacı tıkayıcı uyku apne sendrom (TUAS) lu hastalarda üst solunum yolunda ki tıkayıcı patolojilerin değerlendirilmesine yönelik olarak geliştirilmiş olan iki yöntemin ; uyku endoskopisi(UE) ve uyku magnetik rezonans görüntüleme (MRG) bulgularının değerlendirilmesi ve  karşılaştırılmasıdır.

GEREÇ VE YÖNTEM: Çalışmaya TUAS tanısı olan (AHI>5) toplam 20 hasta dahil edildi. Hastaların uyku ve uyanıklık halinde MRG ile  uvulopalatal bölge, retropalatal bölge ve dil kökü seviyesinde anteroposterior(A-P) çap ve yüzey alan ölçümleri yapıldı. Uyku ve uyanıklık halinde yapılan ölçüm ortalamaları karşılaştırıldı.Bu hastalara ayrıca ameliyathane şartlarında uyku endoskopisi (UE) uygulanarak uvulopalatal,lateral farengeal ve dil kökü bölgesinde tıkanıklık düzeyi yüzde üzerinden değerlendirildi.Elde edilen verilerin korelasyonu istatiksel yöntemlerle değerlendirildi.

BULGULAR:  Uyku MRG değerlendirilmesinde her üç bölgede de uyanık pozisyonda yapılan ölçümlere göre istatiksel olarak anlamlı azalma görüldü(p<0.001). UE ile uvulopalatal ve dil kökü düzeyinde %50 ve üzeri tıkanıklık gözlenen hastaların , çap ve yüzey ölçüm alanları ortalaması %50 den az tıkanıklık saptanan hastalara göre istatiksel olarak anlamlı düzeyde daha düşüktü (p<0.05). Bu nedenle UE ve Uyku MRG yöntemlerinin verileri birbiri ile uyumlu olarak yorumlandı (p<0.05)

SONUÇ: UE bulgularının  daha objektif bir teknik olan Uyku MRG bulguları ile uyumlu olması, UE ‘nin etkinliğini göstermesi açısından önem taşımaktadır. Bununla birlikte UE daha az ekipmanla uygulanabilmekte  ve  operasyon öncesi tıkanıklığa yol açan bölgenin  direk görüntülemesine imkan tanımaktadır. 

Keywords

• Uyku Apnesi,horlama,uyku endoskopisi,MRG,polisomnografi

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