Comparison of rhinomanometry results with polysomnography and physical examination findings in patients with obstructive sleep apnea syndrome

Yıl 2014, Cilt: 24 Sayı: 4, 190 - 194, 25.09.2014

Ali Yüksel

Öz

Objectives: This study aims to investigate the effects of anterior rhinomanometry-induced nasal resistance on obstructive sleep apnea syndrome OSAS patients. Patients and Methods: Between May 2011 and September 2011, 100 volunteer patients 76 males, 24 females; mean age 47.6±11.6 years; range 20 to 71 years who were admitted with complaints of snore, breathing pauses told by their partners, oversleep mood in a daytime and fatigue and diagnosed with OSAS by polysomnography with simple snore were included. Anterior rhinomanometry was applied for all patients and nasal resistance was estimated. Mallampati index and body mass index BMI of patients was calculated. The mean apnea-hypopnea index AHI and minimum oxygen saturation values were measured. Results: There was no significant relationship between nasal resistance and AHI. However, a significant relationship between AHI and Mallampati and BMI values was observed. The AHI values increased, as the Mallampati and BMI values increased. Conclusion: Our study results show that nasal resistance has no significant effect on AHI and minimum oxygen saturation in OSAS patients.

Anahtar Kelimeler

Nasal resistance, obstructive sleep apnea syndrome, rhinomanometry

Obstrüktif uyku apnesi sendromlu hastalarda rinomanometri sonuçlarının polisomnografi ve fizik muayene bulguları ile karşılaştırılması

Öz

Amaç: Bu çalışmada anterior rinomanometri yapılan obstrüktif uyku apne sendromlu OUAS hastalarda nazal direncin etkisi araştırıldı.Hastalar ve Yöntemler: Mayıs 2011 - Eylül 2011 tarihleri arasında, horlama, partnerlerinin ifade ettiği uykuda solunum durması, gündüz aşırı uykululuk hali ve yorgunluk yakınmalarıyla başvuran ve polisomnografi ile OUAS tanısı konan, basit horlamalı 100 gönüllü hasta 76 erkek, 24 kadın; ort. yaş 47.6±11.6 yıl; dağılım 20-71 yıl çalışmaya dahil edildi. Hastaların hepsine anterior rinomanometri uygulandı ve nazal dirençleri hesaplandı. Hastaların Mallampati ve vücut kütle indeksleri VKİ hesaplandı. Polisomnografi ile ortalama apne-hipopne indeksi AHİ ve minimum oksijen satürasyon değerleri ölçüldü.Bulgular: Nazal direnç ile AHİ arasında anlamlı bir ilişki bulunmadı. Ancak, AHİ ile Mallampati ve VKİ indeks değerleri arasında anlamlı bir ilişki bulundu. Hastalarda Mallampati ve VKİ indeks değerleri arttıkça, AHİ’de artış saptandı.Sonuç: Çalışma bulgularımız, OUAS hastalarında nazal direncin AHİ ve minimum oksijen satürasyonu üzerinde anlamlı bir etkisinin olmadığını göstermiştir

Anahtar Kelimeler

Nazal direnç, obstrüktif uyku apne sendromu, rinomanometri

Kaynakça

• Köktürk O. Uykuda solunum bozuklukları; tarihçe, tanımlar, hastalık spektrumu ve boyutu. Tüberküloz ve Toraks 1998;46:187-92.
• Akerstedt T, Billiard M, Bonnet M, Ficca G, Garma L, Mariotti M, et al. Awakening from sleep. Sleep Med Rev 2002;6:267-86.
• Gastaut H, Tassinari CA, Duron B. Polygraphic study of diurnal and nocturnal (hypnic and respiratory) episodal manifestations of Pickwick syndrome. Rev Neurol (Paris) 1965;112:568-79. [Abstract]
• Schwab RJ, Goldberg AN, Pack AL. Sleep apnea syndromes. In: Fishman AP, editor. Fishman’s Pulmonary Diseases and Disorders. New York: McGraw- Hill Book Company; 1998. p. 1617-37.
• ASDA-Diagnostic Classification Steering Commite. The International Classification of Sleep Disorders. Diagnostic and Coding Manual. 2nd ed. Lawrance, KS: Allen Pres Inc; 1997.
• Stradling JR. Sleep-related breathing disorders. 1. Obstructive sleep apnoea: definitions, epidemiology, and natural history. Thorax 1995;50:683-9.
• Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230-5.
• Schwartz AR, Smith PL, Wise RA, Gold AR, Permutt S. Induction of upper airway occlusion in sleeping individuals with subatmospheric nasal pressure. J Appl Physiol (1985) 1988;64:535-42.
• Liistro G, Rombaux P, Belge C, Dury M, Aubert G, Rodenstein DO. High Mallampati score and nasal obstruction are associated risk factors for obstructive sleep apnoea. Eur Respir J 2003;21:248-52.
• Lofaso F, Coste A, d’Ortho MP, Zerah-Lancner F, Delclaux C, Goldenberg F, et al. Nasal obstruction as a risk factor for sleep apnoea syndrome. Eur Respir J 2000;16:639-43.
• Young T, Finn L, Kim H. Nasal obstruction as a risk factor for sleep-disordered breathing. The University of Wisconsin Sleep and Respiratory Research Group. J Allergy Clin Immunol 1997;99:S757-62.
• Young T, Finn L, Palta M. Chronic nasal congestion at night is a risk factor for snoring in a population-based cohort study. Arch Intern Med 2001;161:1514-9.
• Yagi H, Nakata S, Tsuge H, Yasuma F, Noda A, Morinaga M, et al. Morphological examination of upper airway in obstructive sleep apnea. Auris Nasus Larynx 2009;36:444-9.
• Atkins M, Taskar V, Clayton N, Stone P, Woodcock A. Nasal resistance in obstructive sleep apnea. Chest 1994;105:1133-5.
• Mamikoglu B, Houser S, Akbar I, Ng B, Corey JP. Acoustic rhinometry and computed tomography scans for the diagnosis of nasal septal deviation, with clinical correlation. Otolaryngol Head Neck Surg 2000;123:61-8.
• Friedman M, Tanyeri H, La Rosa M, Landsberg R, Vaidyanathan K, Pieri S, et al. Clinical predictors of obstructive sleep apnea. Laryngoscope 1999;109:1901-7.
• Pallanch JF, McCaffrey TM, Kern EB. Evaluation of Nasal Breathing Function with Objective Airway Testing. In: Cummings CW, editor. Otolaryngology Head & Neck Surgery, 3rd ed. Missouri: Mosby-Year Book Inc.; 1988. p. 799-832.
• Riley RW, Powell NB, Guilleminault C. Obstructive sleep apnea syndrome: a review of 306 consecutively treated surgical patients. Otolaryngol Head Neck Surg 1993;108:117-25.
• Galvin JR, Rooholamini SA, Stanford W. Obstructive sleep apnea: diagnosis with ultrafast CT. Radiology 1989;171:775-8.
• Huang L, Williams JE. Neuromechanical interaction in human snoring and upper airway obstruction. J Appl Physiol (1985) 1999;86:1759-63.
• Omur M, Ozturan D, Elez F, Unver C, Derman S. Tongue base suspension combined with UPPP in severe OSA patients. Otolaryngol Head Neck Surg 2005;133:218-23.
• Schwab RJ, Pasirstein M, Pierson R, Mackley A, Hachadoorian R, Arens R, et al. Identification of upper airway anatomic risk factors for obstructive sleep apnea with volumetric magnetic resonance imaging. Am J Respir Crit Care Med 2003;168:522-30.
• Shelton KE, Woodson H, Gay S, Suratt PM. Pharyngeal fat in obstructive sleep apnea. Am Rev Respir Dis 1993;148:462-6.
• Sériès F, St Pierre S, Carrier G. Effects of surgical correction of nasal obstruction in the treatment of obstructive sleep apnea. Am Rev Respir Dis 1992;146:1261-5.
• Kara CO, Tümkaya F, Ardic N, Topuz B. Does tonsillectomy reduce the risk of being a habitual or severe snorer? Eur Arch Otorhinolaryngol 2008;265:1263-8.