title: Clinical application of subjective measurements for OSAS assessment: predictive factors of syndrome severity.
abstract: OBJECTIVE
  To examine the clinical value of subjective evaluations of obstructive sleep apnea syndrome (OSAS) in correlation with syndrome severity as diagnosed with polysomnography.
  
  
  METHODS
  210 patients with mild to severe OSAS were assessed. Objective evaluation included polysomnography. Subjective assessment included full ENT examination, neck circumference (NC) plus body mass index measurements, Mueller maneuver and Epworth Symptom Scale (ESS).
  
  
  RESULTS
  The presence of lateral pharyngeal wall movement, abnormal ESS scoring and male gender can be considered independent risk factors for the prediction of moderate/severe OSAS (p < 0.05). Increased NC can also be considered a clinical risk factor related to male gender and lateral pharyngeal wall movement (p = 0.05).
  
  
  CONCLUSIONS
  Subjective OSAS assessment, including evaluation of lateral pharyngeal wall movement, ESS scoring and NC measurement can safely predict, mainly in males, OSAS severity, as diagnosed with polysomnography. MESSAGE OF THE PAPER: Subjective assessment from the ENT point of view should raise high suspicion towards the early diagnosis of moderate/severe OSAS.
authors.affiliation: ENT Department, Chania General Hospital, Chania, Greece. efklidispr@hotmail.com
authors.forename: Efklidis
authors.initials: E
authors.lastname: Proimos
authors.forename: Devora
authors.initials: D
authors.lastname: Kiagiadaki
authors.forename: Antigoni
authors.initials: A
authors.lastname: Kaprana
authors.forename: Theognosia S
authors.initials: TS
authors.lastname: Chimona
authors.forename: Nicolas J
authors.initials: NJ
authors.lastname: Maroudias
authors.forename: Chariton E
authors.initials: CE
authors.lastname: Papadakis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000403:Airway Resistance / Q000502:physiology; D015992:Body Mass Index; D049628:Body Size; D015331:Cohort Studies; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D055815:Young Adult