Endoscopic evaluation of dynamic narrowing of the pharynx by the Bernouilli effect producing maneuver in patients with obstructive sleep apnea syndrome

Hori, Yohji; Shizuku, Haruhiko; Kondo, Akio; Nakagawa, Hideyuki; Kalubi, Bukasa; Takeda, Noriaki

doi:10.1016/j.anl.2006.05.012

Cited by 27 publications

(30 citation statements)

References 14 publications

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“…In addition to static narrowing, the dynamic narrowing of the retropalatal and retroglossal regions contributes to the pathophysiology of OSA. The significant correlation between the apnea index and these dynamic narrowings constitute a quantitative and predictive alternative to the evaluation and understanding of the upper airway changes in OSA [4].…”

Section: Introductionmentioning

confidence: 99%

A videoendoscopic evaluation of the upper airway in South East Asian adults with obstructive sleep apnea

et al. 2010

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Section: Introductionmentioning

confidence: 99%

A videoendoscopic evaluation of the upper airway in South East Asian adults with obstructive sleep apnea

et al. 2010

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“…They noticed significantly more fluctuation in the airway size, with narrowing during inspiration, and this effect was more prominent at the higher oropharyngeal levels. Hori et al [5] reported significant correlations between the apnea index and both the size of the constricted area of the pharyngeal airway and its narrowing rate during forced inspiration. According to these reports, nasal obstruction is thought to be the trigger of OSAS because negative pressure in the pharyngeal airway increases as the area of the pharyngeal airway shrinks.…”

mentioning

confidence: 99%

The effect of rapid maxillary expansion on pharyngeal airway pressure during inspiration evaluated using computational fluid dynamics

Iwasaki¹,

Takemoto²,

Inada³

et al. 2014

International Journal of Pediatric Otorhinolaryngology

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“…Some studies have shown that the upper airway is narrower and more compliant in OSAHS patients [17,19,34] . In this study, the Muller's maneuver was used to simulate the apnea/hypopnea state during sleep and dynamic 3-D CT imaging was used to detect the airway changes during Muller's maneuver in patients with OSAHS, in order to examine the site and degree of airway obstruction at soft palate level, and to observe the dynamic characteristics of the obstruction.…”

Section: Discussionmentioning

confidence: 99%

“…The Muller's maneuver, consisting of a forced inspiratory effort against a closed mouth and occluded nares, can well demonstrate airway collapsibility of the retropalatal region of the oropharynx [17][18][19] . Borowiecki and Sassin [20] first reported that the Muller's maneuver in the awake patient with severe OSAHS reproduces the airway obstruction that resembles the apnea occurring in OSAHS patients during sleep.…”

mentioning

confidence: 99%

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Evaluation of airway obstruction at soft palate level in male patients with obstructive sleep apnea/hypopnea syndrome: Dynamic 3-dimensional CT imaging of upper airway

Xiao

Xiong

Shi

et al. 2011

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) by using dynamic 3-Dimensional (3-D) CT imaging. A total of 41 male patients who presented with 2 of the following symptoms, i.e., daytime sleepiness and fatigue, frequent snoring, and apnea with witness, were diagnosed as having OSAHS. They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller's maneuver. The soft palate length (SPL), the minimal cross-sectional area of the retropalatal region (mXSA-RP), and the vertical distance from the hard palate to the upper posterior part of the hyoid (hhL) were compared between the two breathing states. These parameters, together with hard palate length (HPL), were also compared between mild/moderate and severe OSAHS groups. Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index (AHI) and the lowest saturation of blood oxygen (LSaO(2))] was examined. The results showed that 31 patients had severe OSAHS, and 10 mild/moderate OSAHS. All the patients had airway obstruction at soft palate level. mXSA-RP was significantly decreased and SPL remarkably increased during Muller's maneuver as compared with the quiet breathing state. There were no significant differences in these airway parameters (except the position of the hyoid bone) between severe and mild/moderate OSAHS groups. And no significant correlation between these airway parameters and the severity of OSAHS was found. The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group. The patients in group with body mass index (BMI)≥26 had higher collapse ratio of mXSA-RP, greater neck circumference and smaller mXSA-RP in the Muller's maneuver than those in group with BMI<26 (P<0.05 for all). It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients. All the OSAHS patients had airway obstruction of various degrees at soft palate level. But no correlation was observed between the airway change at soft palate level and the severity of OSAHS. The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI<26.

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Endoscopic evaluation of dynamic narrowing of the pharynx by the Bernouilli effect producing maneuver in patients with obstructive sleep apnea syndrome

Cited by 27 publications

References 14 publications

A videoendoscopic evaluation of the upper airway in South East Asian adults with obstructive sleep apnea

A videoendoscopic evaluation of the upper airway in South East Asian adults with obstructive sleep apnea

The effect of rapid maxillary expansion on pharyngeal airway pressure during inspiration evaluated using computational fluid dynamics

Evaluation of airway obstruction at soft palate level in male patients with obstructive sleep apnea/hypopnea syndrome: Dynamic 3-dimensional CT imaging of upper airway

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