폐쇄성 수면 무호흡 환자의 후두개 폐쇄 양상
The Pattern of Epiglottic Obstruction in Obstructive Sleep Apnea (OSA) Patients
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Background and Objectives: We evaluated the pattern of epiglottic obstruction in obstructive sleep apnea (OSA) patients, focusing on the results of drug induced sleep endoscopy (DISE), along with a literature review. Materials and Methods: The subjects were 270 Koreans who underwent DISE. Each patient underwent a thorough history taking, physical examination, polysomnography and DISE image evaluated by one otolaryngologist. Results: The prevalence of epiglottic obstruction was 39% (105/270), anterior-posterior complete obstruction was 26% (70/270), and partial obstruction was 13% (35/270). There was no significant correlation between gender, age, body mass index and epiglottis obstruction. The more severe the epiglottic obstruction, the more severe the sleep apnea. The more severe the anterior-posterior obstruction of the tongue base, the more severe the obstruction of the epiglottis (p<0.001). Conclusion: The epiglottis is not well understood compared to other anatomical sites, and it can OSA either alone or simultaneously with other obstructive sites, so researches are needed from a therapeutic point of view.
Abstract
Background and Objectives: We evaluated the pattern of epiglottic obstruction in obstructive sleep apnea (OSA) patients, focusing on the results of drug induced sleep endoscopy (DISE), along with a literature review. Materials and Methods: The subjects were 270 Koreans who underwent DISE. Each patient underwent a thorough history taking, physical examination, polysomnography and DISE image evaluated by one otolaryngologist. Results: The prevalence of epiglottic obstruction was 39% (105/270), anterior-posterior complete obstruction was 26% (70/270), and partial obstruction was 13% (35/270). There was no significant correlation between gender, age, body mass index and epiglottis obstruction. The more severe the epiglottic obstruction, the more severe the sleep apnea. The more severe the anterior-posterior obstruction of the tongue base, the more severe the obstruction of the epiglottis (p<0.001). Conclusion: The epiglottis is not well understood compared to other anatomical sites, and it can OSA either alone or simultaneously with other obstructive sites, so researches are needed from a therapeutic point of view.
참고문헌 (18)
- Senaratna CV, "Prevalence of obstructive sleep apnea in the general population : a systematic review", Sleep Med Rev, 34, pp.70~81 (2017)
- Shahar E, "Sleep-disordered breathing and cardiovascular disease : cross-sectional results of the sleep heart health study", Am J Respir Crit Care Med, 163(1), pp.19~25 (2001)
- Kohler M, "Predictors of long-term compliance with continuous positive airway pressure", Thorax, 65(9), pp.829~832 (2010)
- Caples SM, "Surgical modifications of the upper airway for obstructive sleep apnea in adults : a systematic review and meta-analysis", Sleep, 33(10), pp.1396~1407 (2010)
- Croft CB, "Sleep nasendoscopy : a technique of assessment in snoring and obstructive sleep apnoea", Clin Otolaryngol Allied Sci, 16(5), pp.504~509 (1991)
- Hernández-Gancedo C, "Monitoring sedation in critically ill patients : bispectral index, ramsay and observer scales", Eur J Anaesthesiol, 23(8), pp.649~653 (2006)
- Koo SK, "Analysis of obstruction site in obstructive sleep apnea syndrome patients by drug induced sleep endoscopy", Am J Otolaryngol, 34(6), pp.626~630 (2013)
- Koo SK, "Inter-rater reliability between experienced and inexperienced otolaryngologists using Koo’s drug-induced sleep endoscopy classification system", Eur Arch Otorhinolaryngol, 276(5), pp.1525~1531 (2019)
- Fujita S, "Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome : uvulopalatopharyngoplasty", Otolaryngol Head Neck Surg, 89(6), pp.923~934 (1981)
- Catalfumo FJ, "The epiglottis and obstructive sleep apnoea syndrome", J Laryngol Otol, 112(10), pp.940~943 (1998)
- Cavaliere M, "Awake versus drug-induced sleep endoscopy : evaluation of airway obstruction in obstructive sleep apnea", hypopnoea syndrome, 2013, pp.123(9), 2315~2318
- Lan MC, "Lateral pharyngeal wall collapse associated with hypoxemia in obstructive sleep apnea", Laryngoscope, 125(10), pp.2408~2412 (2015)
- 김동규, "구개수구개인두성형술 후 호전되지 못한 폐쇄성 수면무호흡증 환자에서 약물유도수면내시경을 이용한 결과 분석", 대한이비인후-두경부외과학회지, 57(2), pp.96~102 (2014), 대한이비인후과학회[DOI]
- Joy J, "Assessment of site, degree and pattern of airway obstruction in patients with moderate to severe obstructive sleep apnoea(OSA)using drug induced sleep endoscopy(DISE)and its association with awake fibreoptic evaluation and polysomnography parameters", Indian J Otolaryngol Head Neck Surg, 73(3), pp.315~320 (2021)
- Kim HY, "Patients with epiglottic collapse showed less severe obstructive sleep apnea and good response to treatment other than continuous positive airway pressure : a case-control study of 224 patients", J Clin Sleep Med, 17(3), pp.413~419 (2021)
- 배미례, "Epiglottic Collapse in Obstructive Sleep Apnea", sleep medicine research, 12(1), pp.15~19 (2021), 대한수면학회[DOI]
- Andersen APD, "Obstructive sleep apnea initiated by a lax epiglottis. A contraindication for continuous positive airway pressure", Chest J, 91(4), pp.621~623 (1987)
- Verse T, "Age-related changes in the epiglottis causing failure of nasal continuous positive airway pressure therapy", J Laryngol Otol, 113(11), pp.1022~1025 (1999)