title: Changes of the retrolingual pharynx during the Muller manoeuvre and during sleep in sleep apnoea.
abstract: OBJECTIVE
  To determine whether the retrolingual pharynx shows the same morphometric modifications during the Muller manoeuvre and during drug-induced sleep endoscopy (DISE) with propofol in patients submitted for maxillomandibular advancement surgery.
  
  
  METHODS
  Eighteen patients submitted for maxillomandibular advancement surgery (MMAS) were evaluated endoscopically before and 6 month after surgery in the region of the retrolingual pharynx while seated and lying in dorsal decubitus (supine) while performing the Muller manoeuvre and during DISE with propofol, to verify and measure if the same morphometric changes occur in the retrolingual pharynx during the Muller manoeuvre and during DISE with propofol. The area, anteroposterior, and laterolateral retrolingual pharynx images were acquired using the Sony Vegas 8.0 software and recorded on a DVD. The Image J software was used to measure and compare these images.
  
  
  RESULTS
  An increase in the pharyngeal aperture was observed in all measurements after surgery, specifically in area retrolingual pharynx images. When the Muller manoeuvre was performed, a greater gain (113%) in area retrolingual pharynx measurement was observed when the patient was awake and seated. With the patient was in dorsal decubitus during DISE with propofol there was a greater gain in area retrolingual pharynx measurement (201.33%) in the smaller aperture.
  
  
  CONCLUSIONS
  The Muller manoeuvre after MMAS does not simulate the dimensions of the pharynx that occur during sleep.
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Francisco Veríssimo
authors.initials: FV
authors.lastname: de Mello-Filho
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: savionogueira@yahoo.com.br.
authors.forename: Sávio Nogueira
authors.initials: SN
authors.lastname: da Silva Junior
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Ana Célia
authors.initials: AC
authors.lastname: Faria
authors.affiliation: Department of Anesthesiology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Luis Vicente
authors.initials: LV
authors.lastname: Garcia
mesh_terms: D000328:Adult; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D002508:Cephalometry / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D001239:Inhalation / Q000502:physiology; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D019186:Mandibular Advancement / Q000379:methods; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D010614:Pharynx / Q000473:pathology* / Q000601:surgery; D017286:Polysomnography / Q000379:methods; D011187:Posture / Q000502:physiology*; D015742:Propofol / Q000008:administration & dosage; D012890:Sleep / Q000187:drug effects / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000473:pathology / Q000601:surgery*; D016683:Supine Position / Q000502:physiology; D014741:Video Recording / Q000379:methods
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol
keywords: Muller manoeuvre; Obstructive sleep apnoea; Sleep endoscopy