title: Lateral pharyngeal wall collapse associated with hypoxemia in obstructive sleep apnea.
abstract: OBJECTIVE
  Review drug-induced sleep endoscopy (DISE) findings and correlate the patterns of airway collapse with body mass index (BMI) and objective sleep study respiratory variables, with particular emphasis on oxygen desaturation variables.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  From January 2010 to March 2014, 64 patients underwent DISE, and its findings were registered using the VOTE (velum, oropharynx, tongue base, epiglottis) classification system. Associations were analyzed between DISE, BMI, and polysomnographic parameters.
  
  
  RESULTS
  Complete lateral oropharyngeal collapse was significantly associated with increased severity of obstructive sleep apnea (OSA), reflected by a higher oxygen desaturation index, apnea-hypopnea index, apnea index, the percent of the total time with oxygen saturation level lower than 90%, and minimal oxygen saturation). Complete concentric collapse of the velum and complete lateral oropharyngeal collapse were associated with higher BMI values.
  
  
  CONCLUSIONS
  The results of this study demonstrate a strong association between complete lateral oropharyngeal wall collapse and increased OSA severity, particularly with objective oximetry measures. Patients with a complete lateral oropharyngeal wall collapse may need aggressive treatment strategies because of the high probability of subsequent cardiovascular complications.
  
  
  METHODS
  4
authors.affiliation: Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University Medical Center, Stanford, California, U.S.A.|Department of Otolaryngology-Head & Neck Surgery, Taipei Tzu Chi General Hospital, New Taipei City, Taiwan.|Department of Otolaryngology-Head & Neck Surgery, Tzu Chi University, Hualien, Taiwan.
authors.forename: Ming-Chin
authors.initials: MC
authors.lastname: Lan
authors.affiliation: Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University Medical Center, Stanford, California, U.S.A.
authors.forename: Stanley Y C
authors.initials: SY
authors.lastname: Liu
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Ming-Ying
authors.initials: MY
authors.lastname: Lan
authors.affiliation: Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University Medical Center, Stanford, California, U.S.A.
authors.forename: Rahul
authors.initials: R
authors.lastname: Modi
authors.affiliation: Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University Medical Center, Stanford, California, U.S.A.
authors.forename: Robson
authors.initials: R
authors.lastname: Capasso
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000473:pathology / Q000503:physiopathology*; D017286:Polysomnography; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000473:pathology / Q000503:physiopathology*
keywords: Drug-induced sleep endoscopy; apnea-hypopnea index; oxygen desaturation index; polysomnography