Comparison of two endoscopic examination methods, the Muller maneuver and fiberoptic pharyngoscopy during sleep, in patients with obstructive sleep apnea

Abstract

Objectives: This study was designed to compare two endoscopic examination methods, the Muller maneu­ ver MM and the fiberoptic pharyngoscopy during sleep, both of which are used to detect obstructed seg- ments in patients with obstructive sleep apnea.Patients and Methods: The study included 28 patients 23 males, 5 females; mean age 44.6 years; range 28 to 59 years who underwent uvu- lopalatopharyngoplasty UPPP for snoring or obstruc­ tive sleep apnea. Obstruction was examined both at the level of soft palate and tongue base while the patients were awake and asleep and was scored. The Muller maneuver was performed in the sitting and supine positions. İn addition, fiberoptic pharyngoscopy was performed right after induction of anesthesia. The results of the two methods were compared.Results: Changes in body position were not associ- ated with significant differences in the results of MM.The two methods were found to be highly discor- dant, in that a greater degree of obstruction was noted especially at the level of the soft palate by fiberoptic pharyngoscopy. Conclusion: İt was concluded that the degree of obstruction might be underestimated by MM.

Keywords

• Endoscopy/methods, obstructive sleep apnea, snoring, diagnosis

Obstrüktif uyku apnesi olan hastalarda iki endoskopik muayene yönteminin karşılaştırılması: Müller manevrası ve uyku sırasında fiberoptik farengoskopi

Abstract

Amaç: Bu çalışmada, obstrüktif uyku apnesi olan hastaların üst havayollarındaki daralma bölgelerini tespitetmek için kullanılan endoskopik muayene yöntemlerinden olan Müller manevrası MM ile uyku sırasındafiberoptik farengoskopi uygulaması karşılaştırıldı.Hastalar ve Yöntemler: Horlama veya obstrüktif uykuapnesi nedeniyle uvulopalatofarengoplasti UPPP yapılan 28 hasta çalışmaya alındı. Tüm hastalarda obstrüksiyon, yumuşak damak ve dil kökü seviyelerinde hemuyanıklıkta hem de uyku sırasında incelenerek derecelendirildi. Hastalara MM oturur ve yatar pozisyonlarda uygulandı; buna ek olarak, tüm hastalara ameliyathanede anestezi indüksiyonu sırasında fiberoptik farengoskopi yapıldı. İki uygulamanın sonuçları karşılaştırıldı.Bulgular: Pozisyon değişikliği MM sonuçlarında anlamlı değişikliğe yol açmadı. İki yöntem arasında ileriderecede uyumsuzluk olduğu görüldü. Anestezi indüksiyonu sırasındaki fiberoptik farengoskopik incelemede, MM’ye göre özellikle yumuşak damak seviyesindedaha fazla obstrüksiyon saptandı.Sonuç: Obstrüksiyonun MM ile olduğundan dahadüşük derecede değerlendirilebileceği düşünüldü

Keywords

• Endoskopi/yöntem, obstrüktif uyku apnesi, horlama, tanı.

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