THE CONNECTION BETWEEN POLYSOMNOGRAPHY RESULTS, EPWORTH SCORES AND DRUG-INDUCED SLEEP ENDOSCOPY FINDINGS IN PATIENTS WITH OSAS

Öz

Objective: To determine the usefulness of drug-induced sleep endoscopy (DISE) and evaluate correlations between DISE findings, polysomnography and Epworth sleepiness scale values. Material and Method: Included in this study are patients with major OSAS symptoms and apnea-hypopnea index (AHI) values between 5 and 30 who were scheduled for soft palate surgery. The patients were sedated with propofol (0.25 cc/kg) in the operating room for examination of obstructive regions. Anatomical structures affected by obstruction were observed with flexible endoscopy. The images from this examination were analyzed with Ulead video study. Patients with soft palate pathologies were operated and the endoscopic examination repeated postoperatively. Changes in pre- and post-operative obstruction areas were compared with changes in pre- and post-op PSG and Epworth sleepiness scale values. Results: Changes in retropalatal area values were correlated with changes in AHI values. The most important factor affecting this correlation was the formation of base of tongue pathology, despite being absent preoperatively. We also determined the correlation between patients’ Epworth scores, AHI and retropalatal area. Changes in the retropalatal area following OSAS surgery were correlated with changes in AHI and Epworth scores. Conclusion: DISE is an effective diagnostic technique in OSAS with advantages such as a low radiation risk, cost effectiveness and precise findings.

Anahtar Kelimeler

• Drug-induced sleep endoscopy
• Obstructive sleep apnea
• Epworth sleepiness scale

OUAS HASTALARINDA İLAÇLA İNDÜKLENMİŞ UYKU ENDOSKOPİSİ BULGULARININ POLİSOMNOGRAFİ VE EPWORTH SKALASI SONUÇLARI İLE İLİŞKİSİ

Öz

Amaç: Bu çalışmada tıkayıcı uyku apnesi sendromlu (TUAS) hastalarda ilaçla indüklenmiş uyku endoskopisinin (İİUE) önemini ortaya koymak ve İİUE bulguları ile polisomnografi ve Epworth uyku skalası sonuçları arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntem: Çalışma prospektif olarak planlandı. Çalışmaya major TUAS semptomlarına sahip, apne-hipopne indeksi (AHI) 5 ile 30 arasında olan ve yumuşak damak cerrahisi adayı olan hastalar dahil edildi. Hastalar tıkayıcı lezyonun muayenesi için ameliyathane şartlarında propofol ile (0,25 cc/kg) sedatize edildi. Tıkanma sonucu etkilenen anatomic yapılar fleksible endoskop ile araştırıldı. Bu muayene sonucu elde edilen görüntü Ulead video study programı ile analiz edildi. Yumuşak damak patolojisi olan hastalar opere edilerek operayon sonrası endoskopi işlemi tekrarlandı. Operasyon öncesi ve sonrası tıkanma alanlarındaki değişim ile polisomnografi ve Epworth skalasındaki değişimler karşılaştırıldı. Bulgular: Retropalatal alandaki değişim ile AHI değişimi korele idi. Bu korelasyonu en fazla etkileyen faktör operasyon öncesi olmayan dil kökü patolojisinin ortaya çıkması idi. Ayrıca Epworth skorları ile AHI ve retropalatal alan arasında da korelasyon tespit ettik. TUAS cerrahisi sonrası retropalatal alandaki değişim AHI ve Epworth skorundaki değişim ile korele olarak tespit edildi. Sonuç: İİUE, TUAS hastalarında düşük radyasyon riski, ucuz olması ve değerli verileri sayesinde etkili bir tanı tekniğidir.

Anahtar Kelimeler

• İlaç ile indüklenmiş uyku endoskopisi
• tıkayıcı uyku apnesi
• Epworth uyku skalası

Kaynakça

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