Evaluation of soft palate changes using sleep videofluoroscopy in patients with obstructive sleep apnea.
OBJECTIVE
To quantitatively evaluate the changes in the soft palate (SP) by sleep videofluoroscopy (SVF).


METHODS
Retrospective analysis.


METHODS
Academic tertiary referral center.


METHODS
A total of 63 consecutive patients with snoring or sleep apnea (53 with obstructive sleep apnea [OSA] and 10 simple snorers).


METHODS
All the subjects underwent SVF and nocturnal polysomnography. Sleep videofluoroscopy was performed before and after sleep induction by intravenous injection of low-dose midazolam (2 mg per person) and was recorded during 3 kinds of events: awake, normoxygenation sleep, and desaturation sleep events.


METHODS
Changes in SP length and the angle between inspiratory and expiratory efforts in each group were evaluated according to sleep events; changes in the SP was assessed according to obstruction sites and severity of OSA.


RESULTS
Desaturation sleep events were detected in all patients with OSA but not in simple snorers. In awake events, inspiratory efforts increased the length and angle of the SP in patients with OSA but not in simple snorers. Elongation and angulation were greatest during desaturation sleep events and least during awake events. In normoxygenation events, changes in the SP were significantly larger in patients with OSA than in simple snorers (P < .01 for SP length; P = .03 for SP angle). Elongation of the SP was the biggest in SP-type obstruction.


CONCLUSIONS
Sleep videofluoroscopy quantitatively showed that the SP was considerably elongated and angulated in patients with OSA even in an awake state. It is an easy way to measure the SP changes and may be a useful technique to differentiate OSA from simple snoring with short examination time.
Lee
Chul Hee
CH
Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong Bundang-gu, Seongnam-si, Gyeonggi-do 464-707, South Korea.
Mo
Ji-Hun
JH
Kim
Bong Jik
BJ
Kong
Il Gyu
IG
Yoon
In Young
IY
Chung
Seockhoon
S
Kim
Jae-Hyung
JH
Kim
Jeong-Whun
JW
D000328:Adult; D000368:Aged; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology; D008297:Male; D008874:Midazolam / Q000494:pharmacology; D008875:Middle Aged; D010160:Palate, Soft / Q000503:physiopathology*; D017286:Polysomnography; D012189:Retrospective Studies; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology*; D012913:Snoring / Q000503:physiopathology; D014741:Video Recording
D006993:Hypnotics and Sedatives; D008874:Midazolam