title: Comparison of two endoscopic examination methods, the Muller maneuver and fiberoptic pharyngoscopy during sleep, in patients with obstructive sleep apnea.
abstract: OBJECTIVE
  This study was designed to compare two endoscopic examination methods, the Muller maneuver (MM) and fiberoptic pharyngoscopy during sleep, both of which are used to detect obstructed segments in patients with obstructive sleep apnea.
  
  
  METHODS
  The study included 28 patients (23 males, 5 females; mean age 44.6 years; range 28 to 59 years) who underwent uvulopalatopharyngoplasty (UPPP) for snoring or obstructive sleep apnea. Obstruction was examined both at the level of the soft palate and tongue base while the patients were awake and asleep and was scored. The Muller maneuver was performed in the sitting and supine positions. In addition, fiberoptic pharyngoscopy was performed right after induction of anesthesia. The results of the two methods were compared.
  
  
  RESULTS
  Changes in body position were not associated with significant differences in the results of MM. The two methods were found to be highly discordant, in that a greater degree of obstruction was noted especially at the level of the soft palate by fiberoptic pharyngoscopy.
  
  
  CONCLUSIONS
  It was concluded that the degree of obstruction might be underestimated by MM.
authors.affiliation: Department of Otolaryngology, Medicine Faculty of Hacettepe University, Ankara, Turkey. aesuslu@yahoo.com
authors.forename: Ahmet Emre
authors.initials: AE
authors.lastname: Süslü
authors.forename: Oğuz
authors.initials: O
authors.lastname: Oğretmenoğlu
authors.forename: Tevfik Metin
authors.initials: TM
authors.lastname: Onerci
authors.forename: Omer Taşkin
authors.initials: OT
authors.lastname: Yücel
mesh_terms: D000328:Adult; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000473:pathology; D014059:Tongue / Q000503:physiopathology