Evaluation of the Obstructive Site in Patients with Obstructive Sleep Apnea Using Sleep Endoscopy

Kang, Il Gyu; Lee, Youn Kyu; Min, Kyung Kun; Woo, Joo Hyun; Cha, Heung Eog; Kim, Seon Tae

Abstract

BACKGROUND AND OBJECTIVES
Sleep endoscopy is a valuable modality for an anatomical assessment in patients with snoring and obstructive apnea. The aims of this study is to observe the anatomical obstructive site using sleep endoscopy and to compare the sleep endoscopic findings and the results of the Mueller maneuver in clinical setting.
SUBJECTS AND METHOD
Thirty patients with obstructive sleep apnea syndrome underwent sleep endoscopy. After intravenous administration of midazolam, obstructive events were observed. The levels of obstruction were classified as palatal, palatal with tonsil and palatal with tongue base. Obstruction was defined when the site was collapsed more than 50% compared with normal respiration during the apneic episode.
RESULTS
On sleep endoscopy, retropalatal obstruction was observed in 14 patients (47%). Obstruction in the retropalatal area combined with the tonsillar area was found in 9 patients (30%). Obstruction in the retropalatal area combined with the tongue base area was found in 7 patients (23%). However, the results of Mueller maneuver showed retropalatal obstruction in 19 patients (63%), obstruction in the retropalatal with tonsillar area in 9 patients (30%) and obstruction in the retropalatal with tongue base area in 2 patients (7%).
CONCLUSION
Sleep endoscopy is a useful modality to assess the accurate anatomical site of obstruction during sleep state and provide information useful in planning of further treatment.