scholarly journals Patterns of Upper Airway Obstruction on Drug-Induced Sleep Endoscopy in Patients with Sleep-Disordered Breathing with AHI <5

OTO Open ◽  
2017 ◽  
Vol 1 (3) ◽  
pp. 2473974X1772148
Author(s):  
Sam Spinowitz ◽  
Mimi Kim ◽  
Steven Y. Park
Keyword(s):  
Airway Obstruction ◽  
Sleep Disordered Breathing ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Apnea Hypopnea Index ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Drug Induced Sleep Endoscopy ◽  
Multiple Levels ◽  
Disordered Breathing

Objective To describe the patterns of upper airway obstruction in patients with sleep-disordered breathing with apnea-hypopnea index (AHI) <5 using drug-induced sleep endoscopy (DISE). Study Design Retrospective study. Setting Tertiary care center. Subjects and Methods Inclusion of patients with sleep-disordered breathing with AHI <5 on polysomnography who underwent DISE. Patients <18 years of age were excluded. DISE findings were reported with the VOTEL classification system: the level of collapse was described as occurring at the velum, oropharynx, tongue base, epiglottis, and the lingual tonsils. The degree of collapse was reported as complete, partial, or none. The pattern of the obstruction was described as anteroposterior, lateral, or concentric when applicable. Results A total of 54 patients with sleep-disordered breathing with AHI <5 underwent DISE. Ages ranged from 19 to 65 years. DISE was performed alone in 7% (n = 4) of patients and in conjunction with surgery in 93% (n = 50) of patients. The velum was the most frequent site of upper airway obstruction (85%, n = 46), followed by base of tongue (63%, n = 34), epiglottis (39%, n = 21), lingual tonsils (35%, n = 19), and oropharynx (31%, n = 17). Eighty-three percent (n = 45) of patients had multiple levels of upper airway obstruction, and 15% (n = 8) had a single level of upper airway obstruction. Conclusion Patients with sleep-disordered breathing with AHI <5 have significant upper airway obstruction as seen on DISE. DISE findings indicate that a majority of these patients have multiple levels of upper airway obstruction, which can lead to significant symptoms.

scholarly journals Drug-Induced Sleep Endoscopy vs Awake Müller’s Maneuver in the Diagnosis of Severe Upper Airway Obstruction

2012 ◽  
Vol 148 (1) ◽  
pp. 151-156 ◽  
Author(s):  
Danny Soares ◽  
Adam J. Folbe ◽  
George Yoo ◽  
M. Safwan Badr ◽  
James A. Rowley ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Drug Induced Sleep Endoscopy ◽  
Muller’S Maneuver

THE COMPARISON OF CONFIGURATION, DEGREE AND SITES OF OBSTRUCTION IN PATIENTS WITH SLEEP DISORDERED BREATHING: EXAMINATION USING DRUG-INDUCED SLEEP ENDOSCOPY, MUELLER MANEUVER AND POLYSOMNOGRAPHY

2020 ◽  
pp. 54-57
Author(s):  
NIKEN AGENG RIZKI ◽  
SUSYANA TAMIN ◽  
FAUZIAH FARDIZZA ◽  
RETNO S. WARDANI ◽  
ARIEF MARSABAN ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Laryngopharyngeal Reflux ◽  
Nasal Congestion ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Drug Induced Sleep Endoscopy ◽  
Obstructive Sleep ◽  
Mueller Maneuver

Objective: The purpose of this study is to evaluate the location, configuration, and degree of differences in upper airway obstruction between the Mueller Maneuver (MM) and Drug-induced sleep endoscopy (DISE), thus acquiring a better diagnostic value for SDB patients. Methods: A cross-sectional and analytical descriptive study using retrospective secondary data to evaluate the location, configuration and degree of upper airway obstruction in SDB subjects using the Mueller Maneuver and DISE. Polysomnography (PSG) type 2 was used to determine the SDB degree. Results: Subjects with SDB non-Obstructive sleep apnea (OSA) and OSA show a multilevel obstruction with a different location and configuration due to the various risk factors, such as nasal congestion, laryngopharyngeal reflux, obesity and menopause. Conclusion: Statistical differences in upper airway obstruction configuration between MM and DISE were found in the level of the velum (p=0,036), oropharynx (p<0,001) and epiglottis (p=0,036) and were also found in the obstruction degree of the velum, oropharynx, tongue base and epiglottis with p=0,002; p<0,001; p<0,001 and p<0,001. No statistical difference was found on the lowest oxygen saturation between PSG and DISE (p=0,055).

scholarly journals ERS statement on obstructive sleep disordered breathing in 1- to 23-month-old children

2017 ◽  
Vol 50 (6) ◽  
pp. 1700985 ◽  
Author(s):  
Athanasios G. Kaditis ◽  
Maria Luz Alonso Alvarez ◽  
An Boudewyns ◽  
Francois Abel ◽  
Emmanouel I. Alexopoulos ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Sleep Disordered Breathing ◽  
Objective Assessment ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Sleep Study ◽  
Mandibular Hypoplasia ◽  
Obstructive Sleep ◽  
Obstructive Sleep Disordered Breathing ◽  
Disordered Breathing

The present statement was produced by a European Respiratory Society Task Force to summarise the evidence and current practice on the diagnosis and management of obstructive sleep disordered breathing (SDB) in children aged 1–23 months. A systematic literature search was completed and 159 articles were summarised to answer clinically relevant questions. SDB is suspected when symptoms or abnormalities related to upper airway obstruction are identified. Morbidity (pulmonary hypertension, growth delay, behavioural problems) and coexisting conditions (feeding difficulties, recurrent otitis media) may be present. SDB severity is measured objectively, preferably by polysomnography, or alternatively polygraphy or nocturnal oximetry. Children with apparent upper airway obstruction during wakefulness, those with abnormal sleep study in combination with SDB symptoms (e.g.snoring) and/or conditions predisposing to SDB (e.g.mandibular hypoplasia) as well as children with SDB and complex conditions (e.g.Down syndrome, Prader–Willi syndrome) will benefit from treatment. Adenotonsillectomy and continuous positive airway pressure are the most frequently used treatment measures along with interventions targeting specific conditions (e.g.supraglottoplasty for laryngomalacia or nasopharyngeal airway for mandibular hypoplasia). Hence, obstructive SDB in children aged 1–23 months is a multifactorial disorder that requires objective assessment and treatment of all underlying abnormalities that contribute to upper airway obstruction during sleep.

A trial of drug-induced sleep endoscopy in the surgical management of sleep-disordered breathing

2012 ◽  
Vol 123 (1) ◽  
pp. 277-282 ◽  
Author(s):  
M. Boyd Gillespie ◽  
Ryan P. Reddy ◽  
David R. White ◽  
Christopher M. Discolo ◽  
Frank J. Overdyk ◽  
...  
Keyword(s):  
Surgical Management ◽  
Sleep Disordered Breathing ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Drug Induced Sleep Endoscopy ◽  
Disordered Breathing
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