FREE FULL TEXTAnahtar Kelimeler: Müller manevrası; polisomnografi; uyku apnesi;uyku pozisyonu.
Objectives: The aim of this study was to compare nasopharyngeal
examination findings with those of polysomnography, which
is considered to be the gold standard, in positional and nonpositional
obstructive sleep apnea syndrome (OSAS) patients.
Patients and Methods: The study included 374 patients
(215 males, 159 females; mean age 44.9 years; range 11 to
77 years) presenting with OSAS or simple snoring. Patients
underwent polysomnography recordings and otorhinolaryngologic
examination including fiberoptic nasopharyngoscopy
with the Müller maneuver. The correlation of the data scoredwith
the polysomnographic findings and body mass index
(BMI) was investigated. The findings were assessed using
the Mann Whitney U-test (anatomic findings) and Student
t-test (Müller maneuver).
Results: Body mass index was correlated with apnea-hypopnea
index (AHI), AHI-Lateral AHI-supine, the grade of the
tongue base and neck circumference (p<0.05). In general,
the dominant level of obstruction was at the soft palate level
in patients with severe OSAS. There was a positive correlation
between the grade of lateral obstruction at the soft palate
level and AHI and AHI-lateral (p=0.01, p=0.02, respectively).
The grade of anteroposterior obstruction at the tongue base
level had a significant correlation with AHI- total and AHIsupine
(p<0.05). The grade of the tonsillar hypertrophy
revealed significant correlation with AHI-total and AHI-supine
(p<0.05). There was no significant correlation between the
degree of the nasal septal deviation and AHI (p>0.05).
Conclusion: When upper airway obstruction is evaluated,
AHI and positional AHI values should be used separately.