폐쇄성 수면무호흡증 환자에서 중증도의 임상적 예측인자
Clinical Predictor in Obstructive Sleep Apnea Patient
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Abstract
Background and Objectives：Identifying sites of obstruction and estimating the severity of obstructive sleep apnea (OSA) is the principal goal of clinical examination by an otolaryngologist. There have been many attempts to derive easily obtainable predictors for OSA, which are complementary to polysomnography (PSG) in the evaluation of patients suspected of OSA. The aim of this study is to explore relatively simple and useful test batteries that can predict the presence and severity of OSA. Subjects and Method：Seventy seven patients who complained for snoring and/or sleep apnea, excessive daytime sleepness prospectively underwent PSG, physical examination, cephalometry and nasopharyngosopy. The physical examination included the measurement of tonsil size, palatal position, body mass index (BMI) and thyromental space distance (TMD). The AP diameter of posterior airway space (PAS), the length of soft palate (PNS-P) and inferior displacement of hyoid bone (MP-H) was measured in cephalometry. Retropalatal area and retroglossal area were measured by 4 scales with nasopharyngoscopy during the end of expiration and during Mueller maneuver (MM). Results：Significant correlations with RDI were found in BMI, TMD, MP-H in cephalometry and collapsibility of the retropalatal area in nasopharyngoscopy during MM. BMI, MP-H in cephalometry and collapsibility of the retropalatal area in nasopharingoscopy during MM were found to be good predictors of OSA severity by multivariate linear regression analysis. Conclusion：We suggest that, although it can not replace the role of PSG, the test batterycombined with BMI, cephalometry (MP-H) and nasopharyngoscopy with MM (collapsibility of retropalatal area) can predict the presence and severity of OSA. (Korean J Otolaryngol 2006;49:616-22)
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