TY - JOUR
T1 - Patterns of Upper Airway Obstruction on Drug-Induced Sleep Endoscopy in Patients with Sleep-Disordered Breathing with AHI <5
AU - Spinowitz, Sam
AU - Kim, Mimi
AU - Park, Steven Y.
N1 - Publisher Copyright:
© The Authors 2017.
PY - 2017
Y1 - 2017
N2 - Objective: To describe the patterns of upper airway obstruction in patients with sleep-disordered breathing with apnea-hypopnea index (AHI) <5 using drug-induced sleep endoscopy (DISE). Study Design: Retrospective study. Setting: Tertiary care center. Subjects and Methods: Inclusion of patients with sleep-disordered breathing with AHI <5 on polysomnography who underwent DISE. Patients <18 years of age were excluded. DISE findings were reported with the VOTEL classification system: the level of collapse was described as occurring at the velum, oropharynx, tongue base, epiglottis, and the lingual tonsils. The degree of collapse was reported as complete, partial, or none. The pattern of the obstruction was described as anteroposterior, lateral, or concentric when applicable. Results: A total of 54 patients with sleep-disordered breathing with AHI <5 underwent DISE. Ages ranged from 19 to 65 years. DISE was performed alone in 7% (n = 4) of patients and in conjunction with surgery in 93% (n = 50) of patients. The velum was the most frequent site of upper airway obstruction (85%, n = 46), followed by base of tongue (63%, n = 34), epiglottis (39%, n = 21), lingual tonsils (35%, n = 19), and oropharynx (31%, n = 17). Eighty-three percent (n = 45) of patients had multiple levels of upper airway obstruction, and 15% (n = 8) had a single level of upper airway obstruction. Conclusion: Patients with sleep-disordered breathing with AHI <5 have significant upper airway obstruction as seen on DISE. DISE findings indicate that a majority of these patients have multiple levels of upper airway obstruction, which can lead to significant symptoms.
AB - Objective: To describe the patterns of upper airway obstruction in patients with sleep-disordered breathing with apnea-hypopnea index (AHI) <5 using drug-induced sleep endoscopy (DISE). Study Design: Retrospective study. Setting: Tertiary care center. Subjects and Methods: Inclusion of patients with sleep-disordered breathing with AHI <5 on polysomnography who underwent DISE. Patients <18 years of age were excluded. DISE findings were reported with the VOTEL classification system: the level of collapse was described as occurring at the velum, oropharynx, tongue base, epiglottis, and the lingual tonsils. The degree of collapse was reported as complete, partial, or none. The pattern of the obstruction was described as anteroposterior, lateral, or concentric when applicable. Results: A total of 54 patients with sleep-disordered breathing with AHI <5 underwent DISE. Ages ranged from 19 to 65 years. DISE was performed alone in 7% (n = 4) of patients and in conjunction with surgery in 93% (n = 50) of patients. The velum was the most frequent site of upper airway obstruction (85%, n = 46), followed by base of tongue (63%, n = 34), epiglottis (39%, n = 21), lingual tonsils (35%, n = 19), and oropharynx (31%, n = 17). Eighty-three percent (n = 45) of patients had multiple levels of upper airway obstruction, and 15% (n = 8) had a single level of upper airway obstruction. Conclusion: Patients with sleep-disordered breathing with AHI <5 have significant upper airway obstruction as seen on DISE. DISE findings indicate that a majority of these patients have multiple levels of upper airway obstruction, which can lead to significant symptoms.
KW - drug-induced sleep endoscopy
KW - normal AHI
KW - sleep-disordered breathing
KW - upper airway obstruction
KW - upper airway resistance syndrome
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U2 - 10.1177/2473974X17721483
DO - 10.1177/2473974X17721483
M3 - Article
AN - SCOPUS:85054170074
SN - 2473-974X
VL - 1
JO - OTO Open
JF - OTO Open
IS - 3
ER -