Drug-induced sedation endoscopy versus clinical ...

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Sep 5, 2015 - Keywords OSAHS . Müller maneuver . Drug-induced sedation endoscopy . Friedman staging system . Modified. Mallampati index. Introduction.
Drug-induced sedation endoscopy versus clinical exploration for the diagnosis of severe upper airway obstruction in OSAHS patients Vanessa Zerpa Zerpa, Marina Carrasco Llatas, Gabriela Agostini Porras & José Dalmau Galofre Sleep and Breathing International Journal of the Science and Practice of Sleep Medicine ISSN 1520-9512 Sleep Breath DOI 10.1007/s11325-015-1266-z

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Author's personal copy Sleep Breath DOI 10.1007/s11325-015-1266-z

ENT • ORIGINAL ARTICLE

Drug-induced sedation endoscopy versus clinical exploration for the diagnosis of severe upper airway obstruction in OSAHS patients Vanessa Zerpa Zerpa 1 & Marina Carrasco Llatas 1 & Gabriela Agostini Porras 1 & José Dalmau Galofre 1

Received: 7 April 2015 / Revised: 5 September 2015 / Accepted: 21 September 2015 # Springer-Verlag Berlin Heidelberg 2015

Abstract Background Identifying the sites of obstruction of the upper airway in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) is paramount for surgical planning. The aim of this study is to compare wake physical exam findings to the ones obtained during drug-induced sedation endoscopy (DISE) in the diagnosis of severe collapse of the upper airway in OSAHS patients. Methods A retrospective chart review of OSAHS patients who underwent DISE at our institution during the 2006– 2010 period was conducted. All the patients had previously undergone a physical examination that included modified Mallampati index (MMI), the Müller maneuver (MM), and the Friedman staging system. Level and severity of airway collapse were evaluated. A severe collapse was attributed to obstructions equal or greater than 75 % of the airway. Results A total of 138 patients were included in the study. The incidence of severe airway collapse was compared between DISE and MM; at retropalatal level, no significant difference was found. At retrolingual level, 69 % of patients had severe collapse with DISE in comparison to a 28 % with the MM (p