title: Epiglottis collapse in adult obstructive sleep apnea: A systematic review.
abstract: OBJECTIVE
  To systematically review the international literature evaluating the role of the epiglottis in snoring and obstructive sleep apnea and to explore possible treatment options available.
  
  
  METHODS
  PubMed, Scopus, Embase, Google Scholar, Book Citation Index-Science, CINAHL, Conference Proceedings Citation Index-Science, The Cochrane Collaboration Databases, and Web of Science.
  
  
  METHODS
  The searches were performed from the first year of each database through March 5, 2015.
  
  
  RESULTS
  Fourteen studies about the prevalence of epiglottis collapse in obstructive sleep apnea (OSA) were found. Most involved drug-induced sleep endoscopy studies that indirectly reported their findings about epiglottis collapse. The data suggests that the prevalence of epiglottis collapse in OSA is higher than previously described. The epiglottis has been implicated in 12% of cases of snoring, and sound originating from it has a higher pitch than palatal snoring. Continuous positive pressure (CPAP) surgery and positional therapy in the treatment of epiglottis collapse were also considered. Lateral position of the head may reduce the frequency of epiglottis collapse. With regard to CPAP, available reports suggest that it may accentuate collapse of the epiglottis. Surgery may help reduce snoring in some patients with a lax epiglottis and improve OSA in patients undergoing multilevel surgery.
  
  
  CONCLUSIONS
  Knowledge regarding the role of the epiglottis in adult OSA and snoring patients is limited. The prevalence of this phenomenon in OSA seems to be greater than previously reported, and more research is needed to understand its role in OSA and the best way to treat it.
  
  
  METHODS
  NA.
authors.affiliation: Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, California.|School of Medicine, Stanford University, Stanford, California.
authors.forename: Carlos
authors.initials: C
authors.lastname: Torre
authors.affiliation: Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford Hospital and Clinics, Stanford, California.|School of Medicine, Stanford University, Stanford, California.|Division of Sleep Surgery and Medicine, Department of Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, Hawaii, U.S.A.
authors.forename: Macario
authors.initials: M
authors.lastname: Camacho
authors.affiliation: Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, California.|School of Medicine, Stanford University, Stanford, California.
authors.forename: Stanley Yung-Chuan
authors.initials: SY
authors.lastname: Liu
authors.affiliation: Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, California.|Department of Otolaryngology, Head and Neck Surgery, Cathay General Hospital, Taipei, Taiwan.|School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
authors.forename: Leh-Kiong
authors.initials: LK
authors.lastname: Huon
authors.affiliation: Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, California.|School of Medicine, Stanford University, Stanford, California.
authors.forename: Robson
authors.initials: R
authors.lastname: Capasso
mesh_terms: D000328:Adult; D045422:Continuous Positive Airway Pressure; D004724:Endoscopy / Q000379:methods; D004825:Epiglottis / Q000503:physiopathology*; D006801:Humans; D017286:Polysomnography; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
keywords: Obstructive Sleep Apnea; continuous positive airway pressure; epiglottis; hypopharynx; positional therapy; snoring; surgery; systematic review