title: Comparison of level and degree of upper airway obstruction by Müller's maneuver and drug-induced sleep endoscopy in obstructive sleep apnea patients.
abstract: OBJECTIVE
  This study aimed to compare and analyze the level and degree of observed upper airway obstruction in patients with obstructive sleep apnea (OSA) using Müller's maneuver (MM) and drug-induced sleep endoscopy (DISE). We sought to find a method for evaluating the upper airway that could be used to determine surgical sites.
  
  
  METHODS
  This study included 80 OSA patients who visited Kyung Hee Medical Center and underwent polysomnography (PSG) from March 2013 to March 2014. Obstructive levels observed by MM were classified into retropalatal level, or the lateral wall and retroglossal level. These levels were compared with those determined by DISE through the VOTE classification.
  
  
  RESULTS
  Based on the results of MM and DISE, lateral wall and retropalatal level obstructions showed relatively high conformity, while retroglossal level obstruction exhibited considerable differences. When evaluated at each level, patients with obstruction on MM also showed partial or complete obstruction on DISE at same level, and patients with no obstruction on DISE also showed no obstruction on MM at same level.
  
  
  CONCLUSIONS
  Both examination methods revealed the same obstruction levels in all cases except epiglottic level, but there were some differences in obstructive degree. MM is capable of detecting obstruction levels in the upper airway and can be used to determine surgical sites in cases when DISE cannot be used due to a patient's condition or a clinic's circumstances.
authors.affiliation: Department of Otorhinolaryngology - Head & Neck Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Ah Ra
authors.initials: AR
authors.lastname: Jung
authors.affiliation: Department of Otorhinolaryngology - Head & Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Tae Kyung
authors.initials: TK
authors.lastname: Koh
authors.affiliation: Department of Otorhinolaryngology - Head & Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology - Head & Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Kun Hee
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Otorhinolaryngology - Head & Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Joong Saeng
authors.initials: JS
authors.lastname: Cho
authors.affiliation: Department of Otorhinolaryngology - Head & Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea. Electronic address: drkimsw@hanmail.net.
authors.forename: Sung Wan
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000145:classification* / Q000175:diagnosis; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000145:classification* / Q000175:diagnosis
keywords: Drug-induced sleep endoscopy; Müller's maneuver; Obstructive sleep apnea