title: Analysis of obstruction site in obstructive sleep apnea syndrome patients by drug induced sleep endoscopy.
abstract: OBJECTIVE
  We analyzed site, pattern and degree of obstruction in Korean male obstructive sleep apnea syndrome (OSAS) patients by drug-induced sleep endoscopy (DISE). We also investigated possible links between BMI, AHI and DISE findings.
  
  
  METHODS
  Sixty-nine male patients underwent DISE. DISE findings were reported using our classification system in which modified 'VOTE classification' - obstruction type, site of obstruction, degree of obstruction and anatomical site contributing obstruction - was reported. Associations were analyzed among the results of the polysomnography, patients' characteristics and DISE finding.
  
  
  RESULTS
  Multilevel airway obstruction was found in 84.06% of patients and 15.94% had a unilevel obstruction. Among those with unilevel obstruction, 90.90% had retropalatal level obstruction and 9.10% had retrolingual level obstruction. Palate with lateral pharyngeal wall obstruction (49.28%) is the most common obstruction type of the retropalatal level and tongue with lateral pharyngeal wall (37.68%) is the most common obstruction type of the retrolingual level. Examining the relation between obstruction site according to body mass index (BMI) and severity of OSAS (apnea hypopnea index, AHI), the lateral pharyngeal wall had an increasing tendency associated with higher BMI and higher AHI. But the lateral pharyngeal wall of both levels was statistically significant associated with higher AHI.
  
  
  CONCLUSIONS
  The majority of the Korean male OSAS patients have multilevel obstruction and according to BMI and AHI, the DISE findings indicate that the lateral pharyngeal wall is the most important anatomical site contributing to obstruction regardless of the level at which the obstruction lies.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Busan Saint Mary's Hospital, Busan, Korea. Electronic address: koosookweon@naver.com.
authors.forename: Soo Kweon
authors.initials: SK
authors.lastname: Koo
authors.forename: Jang Won
authors.initials: JW
authors.lastname: Choi
authors.forename: Nam Suk
authors.initials: NS
authors.lastname: Myung
authors.forename: Hyoung Ju
authors.initials: HJ
authors.lastname: Lee
authors.forename: Yang Jae
authors.initials: YJ
authors.lastname: Kim
authors.forename: Young Joong
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000145:classification / Q000473:pathology*; D015992:Body Mass Index; D004825:Epiglottis / Q000473:pathology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007828:Laryngoscopy; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D010160:Palate, Soft / Q000473:pathology; D010614:Pharynx / Q000473:pathology; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000209:etiology*; D014059:Tongue / Q000473:pathology; D014741:Video Recording; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam