THE COMPARISON OF CONFIGURATION, DEGREE AND SITES OF OBSTRUCTION IN PATIENTS WITH SLEEP DISORDERED BREATHING: EXAMINATION USING DRUG-INDUCED SLEEP ENDOSCOPY, MUELLER MANEUVER AND POLYSOMNOGRAPHY

  • NIKEN AGENG RIZKI Otorhinolaryngology Head-Neck Surgery Department, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • SUSYANA TAMIN Otorhinolaryngology Head-Neck Surgery Department, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • FAUZIAH FARDIZZA Otorhinolaryngology Head-Neck Surgery Department, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • RETNO S. WARDANI Otorhinolaryngology Head-Neck Surgery Department, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • ARIEF MARSABAN Anesthesiology Department, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • SAPTAWATI BARDOSONO Clinical Nutrition Department, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • ELVIE ZULKA KAUTZIA RACHMAWATI Otorhinolaryngology Head-Neck Surgery Department, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Abstract

Objective: The purpose of this study is to evaluate the location, configuration, and degree of differences in upper airway obstruction between the Mueller Maneuver (MM) and Drug-induced sleep endoscopy (DISE), thus acquiring a better diagnostic value for SDB patients.


Methods: A cross-sectional and analytical descriptive study using retrospective secondary data to evaluate the location, configuration and degree of upper airway obstruction in SDB subjects using the Mueller Maneuver and DISE. Polysomnography (PSG) type 2 was used to determine the SDB degree.


Results: Subjects with SDB non-Obstructive sleep apnea (OSA) and OSA show a multilevel obstruction with a different location and configuration due to the various risk factors, such as nasal congestion, laryngopharyngeal reflux, obesity and menopause.


Conclusion: Statistical differences in upper airway obstruction configuration between MM and DISE were found in the level of the velum (p=0,036), oropharynx (p<0,001) and epiglottis (p=0,036) and were also found in the obstruction degree of the velum, oropharynx, tongue base and epiglottis with p=0,002; p<0,001; p<0,001 and p<0,001. No statistical difference was found on the lowest oxygen saturation between PSG and DISE (p=0,055).

Keywords: Drug-induced Sleep Endoscopy (DISE), Mueller Maneuver, Obstructive Sleep Apnea (OSA), Polysomnography, Sleep Disordered Breathing (SDB)

References

1. Abdullah VJ, Koutsourelakis I, Ravesloot M, Lee DL, Ha SC, de Vries N, et al. Drug-induced sleep endoscopy. Advanced surgical techniques in snoring and obstructive sleep apnea. San Diego: Plural Publishing; 2013. p. 43–66.
2. Soares MC, Sallum AC, Gonçalves MT, Haddad FL, Gregório LC. Use of Muller's maneuver in the evaluation of patients with sleep apnea: a literature review. Brazilian J Otorhinolaryngol 2009;75:463–6.
3. Jung AR, Koh TK, Kim SJ, Lee KH, Cho JS, Kim SW. Comparison of area and degree of upper airway obstruction by Müller's maneuver and drug-induced sleep endoscopy in obstructive sleep apnea patients. Auris Nasus Larynx 2017;44:57:1–5.
4. Yegïn Y, Çelik M, Kaya KH, Koç AK, Kayhan FT. Comparison of drug-induced sleep endoscopy and Müller's maneuver in diagnosing obstructive sleep apnea using the VOTE classification system. Braz J Otorhinolaryngol 2017;83:445–50.
5. Sihombing CR. Obstructive sleep apnea prevalence in “X” taxi driver in jakarta with snoring and correlate risk factor. Cipto Mangunkusumo Hospital; Jakarta; 2008.
6. Oomen KP, Modi VK. Occult laryngomalacia resulting in obstructive sleep apnea in an infant. Int J Pediatr Otorhinolaryngol 2013;77:1617–9.
7. Ravesloot MJ, de Vries N. One hundred consecutive patients undergoing drug?induced sleep endoscopy: results and evaluation. Laryngoscope 2011;121:2710–6.
8. Phillips NM, Haesler E, Street M, Kent B. Post-anaesthetic discharge scoring criteria: a systematic review. JBI Database Systematic Reviews Implementation Reports 2011;9:1679–713.
9. Kastoer C, Benoist LB, Dieltjens M, Torensma B, de Vries LH, Vonk PE, et al. Comparison of upper airway collapse patterns and its clinical significance: Drug-induced sleep endoscopy in patients without obstructive sleep apnea, positional and non-positional obstructive sleep apnea. Sleep Breathing 2018;22:939–48.
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RIZKI, N. A., TAMIN, S., FARDIZZA, F., WARDANI, R. S., MARSABAN, A., BARDOSONO, S., & RACHMAWATI, E. Z. K. (2020). THE COMPARISON OF CONFIGURATION, DEGREE AND SITES OF OBSTRUCTION IN PATIENTS WITH SLEEP DISORDERED BREATHING: EXAMINATION USING DRUG-INDUCED SLEEP ENDOSCOPY, MUELLER MANEUVER AND POLYSOMNOGRAPHY. International Journal of Applied Pharmaceutics, 12(3). Retrieved from https://innovareacademics.in/journals/index.php/ijap/article/view/39474
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