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

Year 2019, , 255 - 261, 30.09.2019

Volkan Çağlayan Müge Özçelik Korkmaz , Şenol Civelek

https://doi.org/10.16899/jcm.608557

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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