title: The Relation of the Obstruction Site on Muller's Maneuver with BMI, Neck Circumference and PSG Findings in OSAS.
abstract: We investigated relation of the site of obstruction detected on Muller maneuver (MM) with polysomnography (PSG) and physical examination findings. Data of 703 patients admitted to Ankara Numune Education and Research Hospital Sleep Laboratory between 2008 and 2013 were analyzed retrospectively; 394 patients with apnea-hypopnea indexes (AHI) ≥5/h were included. Site of collapse on MM was determined at retrolingual level at anteroposterior (M1) and lateral-lateral (M2) directions; at retropalatal level at anteroposterior (M3) and lateral-lateral (M4) directions. There were 125 (31.7 %) females and 269 (68.3 %) males. BMI had significant positive correlations with M2 (p < 0.001) and M4 (p = 0.002) scores, ESS (p = 0.013) and AHI (p = 0.001). AHI had significant positive correlations with ESS (p = 0.003), M2 (p < 0.001), M3 (p = 0.037) and M4 (p < 0.001) scores and NC (p = 0.001). Minimum oxygen saturation had significant reverse correlations with M1 (p = 0.046), M2 (p < 0.001), M3 (p = 0.003), M4 (p < 0.001), AHI (p < 0.001), ESS (p = 0.003) and BMI (p = 0.001). In OSAS patients, increased BMI, NC and AHI are correlated with lateral pharyngeal wall (LPW) collapse in retropalatal and retrolingual levels on MM. LPW collapse is more valuable to predict OSAS compared to anteroposterior collapse. LPW collapse on MM may be used as a selection criterion for ordering PSG. Further studies are needed to better clarify importance of LPW in OSAS surgery.
authors.affiliation: Ankara Numune Education and Research Hospital 1.ENT Clinic, Ankara, Turkey.
authors.forename: Rauf Oguzhan
authors.initials: RO
authors.lastname: Kum
authors.affiliation: Ankara Numune Education and Research Hospital 1.ENT Clinic, Ankara, Turkey.
authors.forename: Muge
authors.initials: M
authors.lastname: Ozcan
authors.affiliation: Ankara Numune Education and Research Hospital 1.ENT Clinic, Ankara, Turkey.
authors.forename: Yavuz Fuat
authors.initials: YF
authors.lastname: Yılmaz
authors.affiliation: Ankara Numune Education and Research Hospital 1.ENT Clinic, Ankara, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Gungor
authors.affiliation: Ankara Numune Education and Research Hospital 1.ENT Clinic, Ankara, Turkey.
authors.forename: Nurcan
authors.initials: N
authors.lastname: Yurtsever Kum
authors.affiliation: Ankara Numune Education and Research Hospital 1.ENT Clinic, Ankara, Turkey ; Department of Otolaryngology, Hitit University, Çorum, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Unal
keywords: Body mass index; Epworth sleepiness scale; Muller’s maneuver; Obstructive sleep apnea; Polysomnography