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Laryngoscope ; 124(3): 797-802, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24155050

RESUMEN

OBJECTIVES/HYPOTHESIS: To describe upper airway (UA) collapse patterns during drug-induced sleep endoscopy (DISE) in a large cohort of patients with sleep-disordered breathing (SDB) and to assess associations with anthropometric and polysomnographic parameters. STUDY DESIGN: Observational study. METHODS: A total of 1,249 patients [age 47 ± 10 y; apnea-hypopnea index (AHI) 18.9 ± 15.3/h; body mass index (BMI) 27.2 ± 3.7 kg/m(2)] underwent polysomnography and DISE. DISE findings were categorized to the following UA levels: palate, oropharynx, tongue base, and hypopharynx. The degree of collapse was reported as complete, partial, or none. The pattern of the obstruction was described as anteroposterior, lateral, or concentric. Associations between DISE findings and anthropometric and polysomnographic parameters were analyzed. RESULTS: Palatal collapse was seen most frequently (81%). Multilevel collapse was noted in 68.2% of all patients. The most frequently observed multilevel collapse pattern was a combination of palatal and tongue base collapse (25.5%). Palatal collapse was seen most frequently (81%). The prevalence of complete collapse, multilevel collapse, and hypopharyngeal collapse increased with increasing severity of obstructive sleep apnea (OSA). Multilevel and complete collapse were more prevalent in obese patients and in those with more severe OSA. Both higher BMI and AHI values were associated with a higher probability of complete concentric palatal collapse. CONCLUSION: The current study provides an overview of UA collapse patterns in a large cohort of SDB patients who underwent DISE. The associations found in this study may indicate that UA collapse patterns observed during DISE cannot be fully explained by selected baseline polysomnographic and anthropometric characteristics.


Asunto(s)
Obstrucción de las Vías Aéreas/fisiopatología , Endoscopía/métodos , Hipnóticos y Sedantes/administración & dosificación , Síndromes de la Apnea del Sueño/diagnóstico , Adulto , Factores de Edad , Obstrucción de las Vías Aéreas/etiología , Antropometría , Índice de Masa Corporal , Competencia Clínica , Estudios de Cohortes , Endoscopía/efectos adversos , Femenino , Humanos , Infusiones Intravenosas , Modelos Logísticos , Masculino , Midazolam/administración & dosificación , Persona de Mediana Edad , Oportunidad Relativa , Orofaringe/efectos de los fármacos , Orofaringe/fisiopatología , Hueso Paladar/efectos de los fármacos , Hueso Paladar/fisiopatología , Polisomnografía/métodos , Propofol/administración & dosificación , Medición de Riesgo , Factores Sexuales , Sueño/efectos de los fármacos , Síndromes de la Apnea del Sueño/terapia , Estadísticas no Paramétricas
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