Can the Müller maneuver detect multilevel obstruction of the upper airway in patients with obstructive sleep apnea syndrome?

Yıl 2010, Cilt: 20 Sayı: 2, 84 - 88, 20.03.2010

Ümit Tunçel Hasan Mete İnançlı Şefik Sinan Kürkçüoğlu Murat Enöz

Öz

Objectives: Our aim is to figure out the role of Müller maneuver MM to detect the level of upper airway obstruction and the severity of obstructive sleep apnea syndrome OSAS . Patients and Methods: In this study, polysomnographies were made after the routine otorhinolaryngological examination including MM in patients admitted with OSAS suspicion in Ankara Oncology Training and Research Hospital’s Department of Otorhinolaryngology, Sleep Medicine Policlinic. Two-hundred and twenty-one OSAS patients 142 males, 179 females; mean age 47.63 years; range 18 to 82 years were included to the study. Results: There weren’t any significant correlation among apnea hypopnea index AHI results and body mass index BMI , tonsil size and obstruction severity due to MM p>0.05 . Müller maneuver scores are positively correlated to the Epworth sleepiness scale EPSS scores r=0.213 and p<0.001 . Epworth sleepiness scale scores are found to be correlated to BMI and neck circumference p<0.05 . Level of the airway obstruction doesn’t affects the EPSS scores p=0.235 . Also EPSS scores are not affected from uni or multilevel obstruction p=0.088 . Conclusion: The severity of the MM score is not correlated to the severity of OSAS according to AHI results, but it is found to be correlated to EPSS. Vibrating tissues caused local and systemic inflammation in OSAS patients. The correlation between EPSS and MM scores can be explained by this inflammatory process. Further prospective studies have to be done in this field. Müller maneuver in an awake patient might reflect the levels of the obstruction in sleep conditions even though insufficient for figuring out the severity of OSAS.

Anahtar Kelimeler

Müller maneuver, obstructive sleep apnea syndrome, uvulopalatopharyngoplasty, videoendoscopy

Obstrüktif uyku apneli hastalarda Müller manevrasıyla üst hava yolunun çoklu seviyeli tıkanıklıkları tespit edebilir mi?

Öz

Amaç: Müller manevrası MM ’nın obstrüktif uyku apne sendromu OUAS ’nun şiddeti ve üst hava yolundaki tıkanıklık seviyesinin tespitindeki rolü ortaya kondu.Hastalar ve Yöntemler: Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz, uyku ve horlama polikliniğinde, OUAS şüphesiyle başvuran MM’de dahil olmak üzere rutin kulak burun boğaz muayenelerini takiben polisomnografi yapıldı. Çalışmaya 221 OUAS’li hasta 142 erkek, 179 kadın; ort. yaş; 46.63 yıl; dağılım 17-82 yıl dahil edildi.Bulgular: Apne hipopne indeksi AHİ sonuçları ile vücut kitle indeksi VKİ , tonsil büyüklüğü ve MM’de tespit edilen tıkanıklık şiddeti arasında anlamlı fark bulunamadı p>0.05 . Müller manevrası sonuçları ile Epworth uykululuk skalası EPUS arasında anlamlı fark tespit edildi r=0.213 ve p

Anahtar Kelimeler

Müller manevrası, obstrüktif uyku apne sendromu, uvulopalatofarengoplasti, videoendoskopi

Kaynakça

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