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Polysomnographic Findings Versus Degree of Obstruction During Drug-Induced Sleep Endoscopy and Muller’s Maneuver

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Abstract

Purpose: To investigate associations between polysomnographic findings and the severity of upper airway obstructions during Muller’s Maneuver (MM) and Drug-Induced Sleep Endoscopy (DISE) in patients with obstructive sleep apnea syndrome (OSAS). Methods: This was a prospective cohort study. Adult patients newly diagnosed with OSAS in a tertiary sleep center were included consecutively and evaluated by polysomnography and MM. They then underwent DISE in an operating room. The associations between polysomnographic findings and the severity of upper airway obstructions during MM and DISE were assessed. Also, the degree and pattern of obstructions were compared using a modified VOTE questionnaire. Results: 145 patients (mean age 41.5 ± 10.1 years) were enrolled. There were no associations between Respiratory Disturbance Index (RDI), mean and lowest O2 saturation, and body mass index on the one hand, and obstruction degree in MM and DISE (p > 0.05). However, a significant positive correlation was observed between RDI and total VOTE scores in DISE and MM (r = 0.179, p = 0.031 and r = 0.221, p = 0.008 respectively). There were no differences between MM and DISE in diagnosing the degree of obstruction in the velum area (p = 0.687) and the epiglottis (p = 0.50). However, a significant difference was observed between the two techniques in the oropharynx lateral wall (p < 0.001) and tongue base (p = 0.017). Conclusion: Although there was no association between polysomnographic findings and the severity of obstruction in MM and DISE for the separate levels of the upper airway, obstruction severity may be assessed more accurately by total VOTE score, which is representative of RDI severity.

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Acknowledgements

The research was fully sponsored by Otorhinolaryngology Research Center of Tehran University of Medical Sciences.

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Authors and Affiliations

  1. Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Amin Amali, Reza Erfanian, Behrooz Amirzargar, Mohammad Sadeghi, Babak Saedi, Hamed Emami, Reihaneh Heidari, Fatemeh Mirashrafi & Saeed Golparvaran

  2. Department of Otorhinolaryngology-Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran

    Amin Amali, Reza Erfanian, Behrooz Amirzargar, Mohammad Sadeghi, Babak Saedi, Hamed Emami, Reihaneh Heidari, Fatemeh Mirashrafi & Saeed Golparvaran

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Correspondence to Behrooz Amirzargar.

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All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964. Helsinki declaration. The study was approved by the institutional review board and Ethics Committee of Tehran University of Medical Sciences. (IR.TUMS.REC.1394.1697)

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Amali, A., Erfanian, R., Amirzargar, B. et al. Polysomnographic Findings Versus Degree of Obstruction During Drug-Induced Sleep Endoscopy and Muller’s Maneuver. Indian J Otolaryngol Head Neck Surg 75, 2769–2776 (2023). https://doi.org/10.1007/s12070-023-03871-6

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