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Analysis of upper airway obstruction by sleep videofluoroscopy in obstructive sleep apnea: A Large Population-Based Study.
MedLine Citation:
PMID:  21919011     Owner:  NLM     Status:  Publisher    
OBJECTIVES/HYPOTHESIS: To analyze the pattern of the upper airway obstruction in a large cohort of obstructive sleep apnea (OSA) patients using sleep videofluoroscopy (SVF). STUDY DESIGN: Retrospective analysis. METHODS: This study included 922 OSA patients who underwent both polysomnography and SVF. Their mean age, apnea-hypopnea index, and body mass index were 46.8 years, 34.2 per hour, and 26.2 kg/m(2) , respectively. Sleep was induced by intravenous injection of midazolam, and the obstruction pattern was determined on SVF when oxygen saturation dropped by more than 4% in pulse oxymetry. RESULTS: The anatomic structure and airway level, which were most commonly involved in obstruction, were the soft palate (77.9%) and the oropharynx (88.1%), respectively. The soft palate alone was the most common obstructed structure in mild OSA (43.2%), and the combination of the soft palate and the tongue base was more frequent in severe OSA (45.2%). The tongue base or the hypopharynx was progressively more involved in moderate/severe OSA cases (P < .001, respectively), and a multiplicity of obstruction pattern also increased according to OSA severity (P < .001). However, 32.4% of the patients with mild OSA also had multiple obstructive anatomic structures. CONCLUSIONS: Even if multiplicity of obstruction pattern was most commonly associated with severe OSA, almost one third of mild OSA patients also showed multiple anatomic structures and levels of obstruction. Therefore, a precise evaluation for multiplicity of obstruction patterns should precede the decision of a treatment plan, regardless of disease severity.
Chul Hee Lee; Sung-Lyong Hong; Chae-Seo Rhee; Sang-Wook Kim; Jeong-Whun Kim
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-14
Journal Detail:
Title:  The Laryngoscope     Volume:  -     ISSN:  1531-4995     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul.
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