Otorhinolaryngologic examination in obstructive sleep apnea syndrome: the correlation between the severity of sleep disorder and physical examination.
OBJECTIVE
The aim of this study was to compare nasopharyngeal examination findings with those of polysomnography, which is considered to be the gold standard, in positional and nonpositional obstructive sleep apnea syndrome (OSAS) patients.


METHODS
The study included 374 patients (215 males, 159 females; mean age 44.9 years; range 11 to 77 years) presenting with OSAS or simple snoring. Patients underwent polysomnography recordings and otorhinolaryngologic examination including fiberoptic nasopharyngoscopy with the Müller maneuver. The correlation of the data scoredwith the polysomnographic findings and body mass index (BMI) was investigated. The findings were assessed using the Mann Whitney U-test (anatomic findings) and Student t-test (Müller maneuver).


RESULTS
Body mass index was correlated with apnea-hypopnea index (AHI), AHI-Lateral AHI-supine, the grade of the tongue base and neck circumference (p<0.05). In general, the dominant level of obstruction was at the soft palate level in patients with severe OSAS. There was a positive correlation between the grade of lateral obstruction at the soft palate level and AHI and AHI-lateral (p=0.01, p=0.02, respectively). The grade of anteroposterior obstruction at the tongue base level had a significant correlation with AHI- total and AHI-supine (p<0.05). The grade of the tonsillar hypertrophy revealed significant correlation with AHI-total and AHI-supine (p<0.05). There was no significant correlation between the degree of the nasal septal deviation and AHI (p>0.05).


CONCLUSIONS
When upper airway obstruction is evaluated, AHI and positional AHI values should be used separately.
Acar
Baran
B
Department of Otolaryngology, Keçiören Training and Research Hospital, Ankara, Turkey. drbaranacar@gmail.com
Babademez
Mehmet Ali
MA
Karabulut
Hayriye
H
Ciftçi
Bülent
B
Günbey
Emre
E
Karaşen
Riza Murat
RM
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology / Q000379:methods*; D010038:Otorhinolaryngologic Diseases / Q000503:physiopathology*; D010160:Palate, Soft / Q000503:physiopathology; D014066:Palatine Tonsil / Q000473:pathology; D010808:Physical Examination; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000145:classification / Q000503:physiopathology*; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology*