The predictive efficacy of the müller maneuver in uvulopalatopharyngoplasty

Katsantonis, George P.; Maas, Corey S.; Walsh, James K.

doi:10.1288/00005537-198907000-00002

Cited by 120 publications

(62 citation statements)

References 9 publications

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“…Although Sher et al [22] affirmed this maneuver to be successful in predicting the outcome of UPPP with a success rate of 87%, Katsantonis et al [23] reported a 33% success rate, but that they were better at predicting the unsuccessful patients with a ratio of 77.7%. These studies are conflicting, but in our opinion, this method is not deemed unnecessary in the evaluation of OSA patients; we found that when OSA severity increases modified Müller’s maneuver scores increase in both the retropharyngeal and tongue-base regions.…”

Section: Discussionmentioning

confidence: 99%

The Upper Airway Evaluation of Habitual Snorers and Obstructive Sleep Apnea Patients

Karakoç¹,

Akçam²,

Gerek³

et al. 2012

ORL

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Objective: To investigate the relationship between the Apnea Hypopnea Index (AHI) and upper airway examination findings of habitual snorers and obstructive sleep apnea (OSA) patients. Materials and Methods: This study included 264 patients whose tonsils were evaluated in 4 grades. The Mallampati classification was used to determine the relationship between tongue and palate. All patients performed the Müller maneuver in a sitting position. The Fujita classification was used to define the type of obstruction. All patients had polysomnography and were divided into 4 groups according to AHI. Statistical analysis was performed to evaluate the relationship between examination findings and AHI. Results: Of the patients, 133 (50.4%) were habitual snorers, 66 (25%) were mild OSA, 40 (15.2%) were moderate OSA and 25 (9.5%) were severe OSA patients. There was a positive correlation between neck circumference, BMI and AHI in males (p < 0.001). There was a significant difference between patient groups according to Mallampati classification, collapse at the velopharyngeal level and hypopharyngeal level and Fujita classification (all p < 0.001). There were significant relationships between tonsil size, Fujita classification, Mallampati classification, collapse ratios and AHI. Conclusion: We saw that hypopharyngeal area often contributes to obstruction and some examination methods correlate more with AHI. This can aid sleep physicians in the evaluation of OSA patients.

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Section: Discussionmentioning

confidence: 99%

The Upper Airway Evaluation of Habitual Snorers and Obstructive Sleep Apnea Patients

Karakoç¹,

Akçam²,

Gerek³

et al. 2012

ORL

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“…The flexible endoscope is inserted through one of the nostrils, while the patient is first in the sitting and then in the supine position awake, and is directed into the pharyngeal airway. The segment of the airway evaluated for collapse is the epiglottis, tongue base and soft palate, and in addition displacement and movement of the anterior, posterior and lateral pharyngeal walls are evaluated [24]. …”

Section: Methodsmentioning

confidence: 99%

Clinical Application of Subjective Measurements for OSAS Assessment: Predictive Factors of Syndrome Severity

Proimos

Kiagiadaki²,

Kaprana³

et al. 2012

ORL

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Purpose of the Study: To examine the clinical value of subjective evaluations of obstructive sleep apnea syndrome (OSAS) in correlation with syndrome severity as diagnosed with polysomnography. Procedures: 210 patients with mild to severe OSAS were assessed. Objective evaluation included polysomnography. Subjective assessment included full ENT examination, neck circumference (NC) plus body mass index measurements, Mueller maneuver and Epworth Symptom Scale (ESS). Results: The presence of lateral pharyngeal wall movement, abnormal ESS scoring and male gender can be considered independent risk factors for the prediction of moderate/severe OSAS (p < 0.05). Increased NC can also be considered a clinical risk factor related to male gender and lateral pharyngeal wall movement (p = 0.05). Conclusions: Subjective OSAS assessment, including evaluation of lateral pharyngeal wall movement, ESS scoring and NC measurement can safely predict, mainly in males, OSAS severity, as diagnosed with polysomnography. Message of the Paper: Subjective assessment from the ENT point of view should raise high suspicion towards the early diagnosis of moderate/severe OSAS.

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“…All patients underwent fibreoptic nasendoscopy with Mü ller9s manoeuvre [7], rhinomanometry and computed tomography (CT) scanning of the upper airway.…”

Section: Methodsmentioning

confidence: 99%

Laser-assisted uvulopalatoplasty for snoring: does it meet the expectations?

Larrosa

Hernández²,

Morelló³

et al. 2004

European Respiratory Journal

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The high prevalence of habitual snoring (35% of the general population) and the increasing demand for an effective treatment have led, in the last decade, to the generalisation of laser-assisted uvulopalatoplasty (LAUP). However, acceptable studies on its effectiveness are lacking.The present randomised, placebo-controlled study included 25 nonapnoeic and mild obstructive sleep apnoea snorers to evaluate LAUP effectiveness for snoring. Group I received a one-stage LAUP treatment and group II a placebo (simulated snore surgery followed by an oral placebo). Before each treatment and 3 months after, the variables and procedures assessed were: body weight; sleepiness (Epworth sleepiness scale); quality of life (SF-36); subjective snoring intensity (0-10 analogue scale); objective snoring intensity (average decibel intensity); snoring index (number of snores per hour); and apnoea/hypopnea index.No differences were observed in body weight, sleepiness, quality of life, subjective and objective intensity, and frequency of snoring, and apnoea/hypopnea index between the groups before and 3 months after treatment.In conclusion, this study provides evidence of the lack of effectiveness of one-stage laser-assisted uvulopalatoplasty for snoring in nonapnoeic and mild obstructive sleep apnoea patients, with the result that it does not meet the expectations generated by the procedure. Laser-assisted uvulopalatoplasty (LAUP) is an outpatient procedure that involves partial resection of the uvula and soft palate using a laser. It is usually offered as a treatment for snoring or as an alternative treatment in mild obstructive sleep apnoea (OSA). However, methodologically accepted studies on the effectiveness of this treatment are limited since randomised placebo-controlled studies are lacking [1]. The high prevalence of habitual snoring (35% of the general population) [2] and the increasing demand for an effective treatment have led, in the last decade, to the generalisation of LAUP. Its indication has probably been favoured by the widespread belief that surgical procedures are more decisive. Furthermore, disparate results concerning this procedure have been published on the basis of objective measurements of snoring before and after treatment [3][4][5]. This, together with the potential risks and complications of LAUP [1], has cast doubt on the need for treating nonapnoeic snorers [6], and the high cost of treating a growing number of patients has led to the usefulness of LAUP being challenged. Thus, further evidence in support of this treatment is warranted. Accordingly, the authors of the present study conducted a prospective, randomised, placebo-controlled study in patients whose main symptom was disruptive snoring (male sex, age range 30-60 yrs, body mass index (BMI) range 25-30 kg?m -2 , apnoea/ hypopnea index (AHI) f30 and considered to be palatal snorers) to evaluate the effect of LAUP in relieving snoring both subjectively and objectively. Material and methods Study subjectsEntry criteria specified: an initial c...

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The predictive efficacy of the müller maneuver in uvulopalatopharyngoplasty

Cited by 120 publications

References 9 publications

The Upper Airway Evaluation of Habitual Snorers and Obstructive Sleep Apnea Patients

The Upper Airway Evaluation of Habitual Snorers and Obstructive Sleep Apnea Patients

Clinical Application of Subjective Measurements for OSAS Assessment: Predictive Factors of Syndrome Severity

Laser-assisted uvulopalatoplasty for snoring: does it meet the expectations?

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