[Predictive value of sleep nasendoscopy and the Müller maneuver in uvulopalatopharyngoplasty for the obstructive sleep apnea syndrome].

OBJECTIVE

To improve the therapy effect of uvulopalatopharyngoplasty (UPPP) for the obstructive sleep apnea syndrome (OSAS) with the use of sleep pharyngolaryngoscopy and the Müller maneuver to localize pharyngeal airway collapse.

METHOD: Twenty-eight patients with OSAS were divided into two groups respectively based on findings of Müller maneuver and sleep pharyngolaryngoscopy: Type I had only oropharyngeal(soft palate and palatine tonsil) collapse and type II had oropharyngeal collapse with hypopharyngeal collapse. All outcome of PSG after UPPP was analyzed.

RESULT: 1. In Type I, the change of the average apnea hypopnea index (AHI) and the lowest SaO2 before and after UPPP was 52.7 to 19.7 (P < 0.01), 63.1% to 80.0% (P < 0.01) using Müller maneuver, and 48.6 to 18.7(P < 0.01), 65% to 80%(P < 0.01) using sleep pharyngolaryngoscopy respectively; In type II, the change was respectively 54.7 to 38.6(P > 0.05), 60.7% to 67.0%(P > 0.05) using Müller maneuver, and 59 to 34(P < 0.01), 59% to 71%(P < 0.05) using sleep pharyngolaryngoscopy. 2. Surgical response rate in type I was compared with type II: 68.4% VS 22.2% (P < 0.01) using Müller maneuver and 73.3% VS 30.8% (P < 0.05) using sleep pharyngolaryngoscopy, respectively.

CONCLUSION

Endoscopic pharyngeal assessment of OSAS patients has clinical value for the improvement of UPPP outcome.