JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2016, Vol. 30 ›› Issue (5): 29-32.doi: 10.6040/j.issn.1673-3770.0.2016.340

Previous Articles     Next Articles

Endoscopy with Müllers maneuver and airway pressure measurement method on the evaluation of the upper airway of obstructive sleep apnea hypopnea syndrome.

TIAN Xu, HUO Hong, LI Wuyi, WANG Jian, YANG Dahai   

  1. Department of Otolaryngology &Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2016-08-03 Online:2016-10-20 Published:2016-10-20

Abstract: Objective To compare daytime video-endoscopy with Müllers maneuver and nocturnal airway pressure measurement for upper airway(UA)assessment in patients with obstructive sleep apnea and hypopnea syndrome(OSAHS), in order to explore the clinical value of daytime endoscopy in airway evaluation. Methods A total of 125 OSAHS cases were evaluated by daytime video-endoscopy with Müllers maneuver to determine the sites of obstruction and patterns of collapse. The cases also underwent nocturnal pressure measurements(ApneaGraph, AG)to identify obstruction sites. The results of the two methods were compared. Results Endoscopy with Müllers maneuver detected retropalatal obstruction in all cases, of which 74 had retroglossal obstruction, and the patterns of collapse were different. AG results showed that lower apnea hypopnea index(AHI)and the proportion of lower AHI were significantly higher in multilevel obstruction group than in isolated retropalatal obstruction group(all P<0.01). Conclusion Daytime endoscopy with Müllers maneuver is of clinical value to evaluate the sites of obstruction and patterns of UA collapse. Combined with AG, it can help to guide the choice of surgical plan.

Key words: Sleep apnea hypopnea syndrome, obstructive, Video-endoscopy, Manometry, Upper airway, Müllers maneuver

CLC Number: 

  • R766.7
[1] Chai-Coetzer C L, Luo Y M, Antic N A, et al. Predictors of long-term adherence to continuous positive airway pressure therapy in patients with obstructive sleep apnea and cardiovascular disease in the SAVE study[J]. Sleep, 2013, 36(12):1929-1937.
[2] Borowiecki B D, Sassin J F. Surgical treatment of sleep apnea[J]. Arch Otolaryngol, 1983, 109(8):508-512.
[3] 李五一, 倪道凤, 姜鸿, 等. OSAS患者咽腔阻塞定位预测UPPP疗效[J]. 临床耳鼻咽喉科杂志, 2003, 17(3):145-146. LI Wuyi, NI Daofeng, JIANG Hong, et al. Predictive value of sleep nasendoscopy and the Müller maneuver in uvulopalatopharyngoplasty for the obstructive sleep apnea syndrome[J]. Clin J Otorhinolarynol, 2003, 17(3):145-146.
[4] Aboussouan L S, Golish J A, Wood B G, et al. Dynamic pharyngoscopy in predicting outcome of uvulopalatopharyngoplasty for moderate and severe obstructive sleep apnea[J]. Chest, 1995, 107(4):946-951.
[5] Sher A E, Thorpy M J, Shprintzen R J, et al. Predictive value of Müller maneuver in selection of patients for uvulopalatopharyngoplasty[J]. Laryngoscope, 1985, 95(12):1483-1487.
[6] 韩德民, 叶京英, 李彦茹, 等. 上气道持续压力测定预测悬雍垂腭咽成形术的疗效[J]. 中华耳鼻咽喉头颈外科杂志, 2006, 4l(10):753-758. HAN Demin, YE Jingying, LI Yanru, et al. Preoperative overnight airway pressure measurement for predicting the outcome of revised uvulopalatopharyngoplasty[J]. Chin J Otorhinolarynol Head Neck Surg, 2006, 41(10):753-758.
[7] 神平, 李五一, 田旭, 等. 上气道测压阻塞定位在阻塞性睡眠呼吸暂停低通气综合征外科治疗中的应用[J]. 中华耳鼻咽喉头颈外科杂志, 2010, 45(12):1008-1013. SHEN Ping, LI Wuyi, TIAN Xu, et al. Outcomes of upper airway reconstructive surgery for moderate to severe obstructive sleep apnea syndrome based on upper airway pressure measurements[J]. Chin J Otorhinolarynol Head Neck Surg, 2010, 45(12):1008-1013.
[8] Tvinnereim M, Mitic S, Hamsen R K. Plasma radiofrequency preceded by pressure recording enhances success for treating sleep-related breathing disorders[J]. Laryngoscope, 2007, 117(4):73l-736.
[9] 霍红, 李五一, 田旭, 等. 鼻咽通气管用于上气道阻塞定位临床价值的初步研究[J]. 中华耳鼻咽喉头颈外科杂志, 2014, 49(9):743-747. HUO Hong, LI Wuyi, TIAN Xu, et al. Preliminary research on clinical value of localization of upper airway obstruction with nasopharyngeal airway combined with polysomnography[J]. Chin J Otorhinolarynol Head Neck Surg, 2014, 49(9):743-747.
[10] 田旭, 李五一, 霍红, 等. 上气道测压与Friedman分型在上气道阻塞平面判断中的相关性研究[J]. 中华耳鼻咽喉头颈外科杂志, 2011, 46(8):622-627. TIAN Xu, LI Wuyi, HUO Hong, et al. Clinical value of upper airway pressure measurement and Friedman staging system in preoperative evaluation for obstructive sleep apnea hypopnea syndrome[J]. Chin J Otorhinolarynol Head Neck Surg, 2011, 46(8):622-627.
[11] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会咽喉学组. 阻塞性睡眠呼吸暂停低通气综合征诊断依据和外科治疗指南[J]. 中华耳鼻咽喉头颈外科杂志, 2009, 44(2):95-96.
[12] Lee C H, Won T B, Cha W, et al. Obstructive site localization using multisensor manometry versus the Friedman staging system in obstructive sleep apnea[J]. Eur Arch Otorhinolaryngol, 2008, 265(2):171-177.
[13] Ritter C T, Trudo F J, Goldberg A N, et al. Quantitative evaluation of the upper airway during nasopharyngoscopy with the Müller maneuver[J]. Laryngoscope, 1999, 109(6):954-963.
[14] Abdullah B, Rajet K A, Abd Hamid S S, et al. A videoendoscopic evaluation of the upper airway in South East Asian adults with obstructive sleep apnea[J]. Sleep Breath, 2011, 15(4):747-754.
[15] Hsu P P, Tan A K, Tan B Y, et al. Uvulopalatopharyngoplasty outcome assessment with quantitative computer-assisted videoendoscopic airway analysis[J]. Acta Otolaryngol, 2007, 127(1):65-70.
[1] WANG Xiaoqing, WANG Yuyu, QIU Jinwei, XU Jinxia, ZHU Mei. The effect of orofacial muscle functional training on snoring indicators and sleep quality in patients with snoring [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(2): 101-107.
[2] LI Yanru, SHI Yunhan, CAO Lili, LIAO Jianhong, KANG Dan, FEI Nanxi, HAN Demin. Comparison of upper airway anatomical changes during mandibular protrusion and with mandibular advancement device use [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 6-14.
[3] ZENG Bin, LÜ Dan, REN Jia, HU Juanjuan, YU Lingyu, LU Huan, YANG Hui. Application of laryngeal microsurgery in severe neonatal upper airway obstruction [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 95-99.
[4] YANG Mu,XIAO Xuping. Research progress on short lingual frenulum and obstructive sleep apnea in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(3): 100-105.
[5] WANG Huan, ZHANG Yinjie, HUANG Qingfeng, SHI Lejuan, CHEN Xiangping. Preliminary study of rhinomanometry and acoustic rhinometry for normal adults in Chongming, Shanghai [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(1): 56-60.
[6] ZHANG Bingwen, CHEN Rongrong, WU Yuanqing, XU Jinjing, JIANG Liang, QI Jianwei. Value of 128-slice CT 3D reconstruction in the Müller state in the evaluation of the upper airway obstruction plane in patients with OSAS [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 90-94.
[7] JIN Xing, HU Dayu, ZHU Li, DENG Furong, LIU Junxiu. Correlation between PM2.5 and upper airway resistance in patients with allergic rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 77-80.
[8] CHEN Ying, XUE Mingxin. A randomized clinical observation of acupoint application combined with massage in the treatment of children with upper airway cough syndrome [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 131-134.
[9] JING Shanglin.. Diagnosis and treatment of upper airway cough syndrome in children. [J]. J Otolaryngol Ophthalmol Shandong Univ, 2017, 31(6): 87-91.
[10] LU Xiaofeng, ZHU Min, WANG Bing. Treatment for obstructive sleep disordered breathing from the oral angle. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(5): 13-17.
[11] ZHANG Baolin, GUO Rui, GONG Weixi, MA Jianling, LI Xianlong. Reducing the volume of soft palate and tongue with low-temperature plasma combined with pharyngeal mucosal relaxation suture in patients with obstructive sleep apnea hypopnea syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(5): 19-22.
[12] MEI Xubin, ZOU Xinbo, ZHAO Limin, LIU Wenjun. Obstructive sleep apnea syndrome combined with marfan's syndrome in 1 case [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(5): 23-24.
[13] HE Cheng. Misdiagnosis of upper airway cough syndrome in children (140 cases report) [J]. J Otolaryngol Ophthalmol Shandong Univ, 2013, 27(6): 69-71.
[14] YAN Zhi-qiang1,2, SUN Jian-jun1. Multilevel surgery of upper airway for adults with obstructive sleep apnea-hypopnea syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2012, 26(1): 4-8.
[15] HE Shou-huan,CHEN Bin,YIN Shan-kai,SU Kai-ming,JIANG Xiao . Morphological changes of the upper airway in OSAHS patients with UPPP
[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(5): 385-388 .
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!