Journal of Clinical Otolaryngology Head and Neck Surgery (임상이비인후과)

The Busan, Ulsan, Gyeoungnam Branch of Korean Society of Otolaryngology-Head and Neck Surgery (대한이비인후과학회 부산,울산,경남 지부회)
권호 표지

Comparison of Clinical Characteristics and Effects of Modified Jaw Thrust Maneuver During Drug-Induced Sleep Endoscopy (DISE) between Positional and Non-Positional Obstructive Sleep Apnea Patients

  • Moon, Ji Seung (Department of Otorhinolaryngology, Busan Saint Mary's Hospital) ;
  • Koo, Soo Kweon (Department of Otorhinolaryngology, Busan Saint Mary's Hospital) ;
  • Kim, Young Joong (Department of Otorhinolaryngology, Busan Saint Mary's Hospital) ;
  • Lee, Sang Hoon (Department of Otorhinolaryngology, Busan Saint Mary's Hospital) ;
  • Lee, Ho Byoung (Department of Otorhinolaryngology, Busan Saint Mary's Hospital) ;
  • Park, Geun Hyung (Department of Otorhinolaryngology, Busan Saint Mary's Hospital) ;
  • Lee, Sang Jun (Department of Otorhinolaryngology, Sleep laboratory, Busan Saint Mary's Hospital)
  • ;
  • 구수권 (부산성모병원 이비인후과) ;
  • ;
  • ;
  • ;
  • ;
  • Received : 2018.09.19
  • Accepted : 2018.11.27
  • Published : 2018.12.30

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Abstract

Background and Objectives : Positional OSAS is characterized by an apnea-hypopnea index (AHI) score >5, which, while sleeping in the supine position, is double that in non-supine position. This study was performed to compare the clinical characteristics of positional OSAS and non-positional OSAS patients, and the effects of the modified jaw thrust maneuver during drug-induced sleep endoscopy (DISE) between positional OSAS and non-positional OSAS patients. Materials and Methods : 68 positional OSAS patients and 19 non-positional OSAS patients were included. They all underwent full-night polysomnography and DISE. The modified jaw thrust maneuver was introduced during DISE. Airway structural changes induced by the modified jaw thrust maneuver were evaluated and documented. Results : There were no statistically significant differences in Friedman stage or tonsil grade, body mass index, Epworth sleepiness scale (ESS) score, blood pressure, AHI, or obstructive pattern between the positional and non-positional OSAS patients. However, mean arterial oxygen saturation (SaO2), lowest SaO2, and total arousal index values were more severe in the non-positional OSAS patients. After introduction of the modified jaw thrust maneuver, retrolingual level obstruction showed a tendency toward a higher rate of airway opening in positional OSAS patients than in non-positional OSAS patients. Conclusions : The effects of a mandibular advancement device (MAD) can be estimated by carrying out a modified jaw thrust maneuver during DISE. The tendency toward a higher rate of airway opening in positional OSAS patients than non-positional OSAS patients in retrolingual level obstruction after jaw thrust maneuver introduced during DISE may be clinically important for MAD.

Keywords

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