| Objective: Müller’s maneuver(MM)and drug-induced sleep endoscopy(DISE)were compared to observe the level and degree of upper airway obstruction in patients with OSA to determine whether drug-induced sleep endoscopy affects the plane of obstruction in OSA.Methods: This study included 62 OSA patients who visited the Second People’s Hospital of Shenzhen and underwent polysomnography(PSG)from December 2019 to January 2021 The same patient underwent MM and DISE examinations to observe the plane of airway obstruction(velum level,oropharynx lateral walls level,tongue base level and epiglottis level),which were compared by VOTE classification.Results: Based on the results of MM and DISE,velum level obstructions showed No significant difference(P > 0.05),However,it was statistically significant at the level of the oropharynx,base of the tongue,and epiglottis(P< 0.05),When evaluated at each level,patients with MM without obstruction showed partial or complete obstruction on the DISE at the same level,patients with partial obstruction on MM also showed partial,even complete obstruction on DISE at the same level;and patients with no obstruction on DISE also showed no obstruction on MM at same level.Conclusion: Although DISE is drug-induced simulated sleep,it does not affect the judgment of the obstructive plane of OSA;Both examination methods can detect the site of obstruction in patients with OSA,but differences may exist in the degree and level of obstruction,The information obtained in the awake state can be inaccurate and underestimate the degree of obstruction at various levels,Therefore,we recommend that patients with OSA or those who do not demonstrate a specific level of obstruction on MM should undergo DISE to correctly identify and assess the level of obstruction and improve the accuracy of diagnosis and treatment and the cure rate of the procedure.Objective: To explore the difference of Cine-MRI between awake and sleeping OSA patients,compare the positive rate,advantages and disadvantages of Sleep-MRI and DISE in the diagnosis of upper airway localization in OSA patients,and explore its clinical application value.Methods: This study included 42 OSA patients who visited the Department of Otorhinolaryngology of the Second People’s Hospital of Shenzhen andunderwent polysomnography(PSG)from December 2019 to January 2021 underwent awake and sleep Cine-MRI and drug-induced sleep endoscopy,respectively,to determine the site of upper airway obstruction in patients with OSA.Results: There were significant differences in Cine-MRI between awake and asleep states at each obstruction level of the airway(velum level,oropharynx lateral walls level,tongue base level and epiglottis level)(P <0.05).Comparing DISE with Sleep-MRI in judging the positive rate of obstruction at velum level,oropharynx lateral walls level,tongue base level and epiglottis level in patients with OSA,the positive rate of DISE and Sleep-MRI at velum level was the same [all 100%(42 cases)],the positive rate of DISE at oropharynx lateral walls level was higher than that of Sleep-MRI[95.24%(40 cases)vs 85.71%(36 cases)],and the positive rate of DISE at tongue base level and epiglottis level was lower than that of Sleep-MRI I[61.90%(26 cases)vs 69.05%(29 cases),and 50.00%(21 cases)vs 61.90%(26 cases),respectively],the difference was not statistically significant(P>0.05);However,there was a significant difference in the examination time between the two groups(P < 0.05).Conclusion: Upper airway Cine-MRI can only reflect anatomical abnormalities in awake state,and MRI examination in natural sleep state can more comprehensively,truly and objectively reflect the obstruction plane of OSA patients;there is no significant statistical difference in the positive rate of upper airway obstruction plane between DISE and Sleep-MRI;both can be considered as preoperative examination means for OSA patients,and both can accurately reflect the upper airway obstruction plane of patients;we recommend DISE examination in clinical applicability. |
PDF Full Text Request