title: Identification of obstructive sites and patterns in obstructive sleep apnoea syndrome by sleep endoscopy in 614 patients.
abstract: The aim of this study was to analyze and report sites and patterns of obstruction observed during sleep endoscopy in a large group of patients and suggest consequent therapeutic prescriptions. 614 consecutive patients who approached the Centre for Diagnosis and Treatment of Respiratory Sleep Disorders underwent sleep endoscopy. We used propofol to induce sleep, monitoring the value of bispectral index to evaluate the depth of sedation. For each patient, we recorded obstruction sites,obstruction patterns and the effects of the mandibular pull-up manoeuvre on both obstruction and snoring. We ascertained that, in almost all patients, the noise of snoring was generated at the oropharyngeal level. The obstruction at the oropharyngeal level, either in isolation or in combination with other structures, is far more common. The mandibular pull-up manoeuvre was effective in reducing or resolving the obstruction in a large number of patients, even though their AHI values were high. For those patients having an AHI over 15, we point out the various therapeutic indications gained from the sleep endoscopy examinations. Drug-induced (propofol) sleep endoscopy can be considered be a safe procedure, easily practicable, valid and reliable; we therefore consider it a fundamental clinical investigation that can be essential when choosing treatment.
authors.affiliation: Department of Otolaryngology, S. Pio X Hospital, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Salamanca
authors.forename: F
authors.initials: F
authors.lastname: Costantini
authors.forename: A
authors.initials: A
authors.lastname: Bianchi
authors.forename: T
authors.initials: T
authors.lastname: Amaina
authors.forename: E
authors.initials: E
authors.lastname: Colombo
authors.forename: F
authors.initials: F
authors.lastname: Zibordi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D055815:Young Adult
keywords: Mandibular pull-up manoeuvre; Obstructive sleep apnoea syndrome; Oral device; Sleep endoscopy
references.citation: Laryngoscope. 2001 Jan;111(1):175-6
references.pmid: 11192890
references.citation: B-ENT. 2010;6(2):97-103
references.pmid: 20681361
references.citation: Acta Otorhinolaryngol Ital. 2010 Apr;30(2):73-7
references.pmid: 20559476
references.citation: Laryngoscope. 2005 Mar;115(3):538-40
references.pmid: 15744173
references.citation: Otolaryngol Head Neck Surg. 2010 Feb;142(2):218-24
references.pmid: 20115978
references.citation: Presse Med. 1992 Feb 15;21(6):249-52
references.pmid: 1532638
references.citation: Acta Otorhinolaryngol Ital. 2012 Feb;32(1):48-53
references.pmid: 22500068
references.citation: Acta Otorhinolaryngol Ital. 2012 Aug;32(4):252-5
references.pmid: 23093815
references.citation: Clin Otolaryngol Allied Sci. 1991 Oct;16(5):504-9
references.pmid: 1742903
references.citation: Clin Otolaryngol Allied Sci. 1993 Dec;18(6):480-4
references.pmid: 8877224
references.citation: Eur Arch Otorhinolaryngol. 2003 Feb;260(2):91-5
references.pmid: 12582786
references.citation: Clin Otolaryngol Allied Sci. 1995 Aug;20(4):360-4
references.pmid: 8548973
references.citation: Acta Otorrinolaringol Esp. 2005 Jan;56(1):17-21
references.pmid: 15747719
references.citation: J Laryngol Otol. 2005 Feb;119(2):106-12
references.pmid: 15829062
references.citation: Laryngoscope. 1985 Dec;95(12):1483-7
references.pmid: 4068867
references.citation: Acta Otorhinolaryngol Ital. 2011 Apr;31(2):103-8
references.pmid: 22064751
references.citation: Acta Otorhinolaryngol Ital. 2011 Jun;31(3):149-53
references.pmid: 22058592