Abstract：
OBJECTIVE: Obstructive sleep apnea (OSA) is a prevalent disorder, with oral breathing influencing its severity. Expiratory velopharyngeal obstruction (EVO), observed during drug-induced sleep endoscopy (DISE), may contribute to oral breathing in OSA patients. EVO results in obstruction between the pharynx and nasal cavity during expiration. This study aims to identify factors associated with positive EVO during DISE.
METHODS: Case series.
METHODS: Tertiary Medical Center.
METHODS: Seventy-two OSA patients underwent clinical evaluation, polysomnography, and DISE, utilizing interventions like intraoral negative airway pressure (iNAP), mouth closure, and oral appliances (OAs) in supine positions with head rotation. The findings, classified under velopharynx, oropharynx, tongue base, epiglottis, included the presence of EVO.
RESULTS: The results demonstrated that interventions including mouth closure and iNAP were associated with increased observation of EVO (43.1% and 34.7%) compared to OA (20.1%). However, head rotation was associated with decreased presence of EVO during DISE compare to supine (26% vs 35.8%). Noticeably, per 1 year increase of age was associated with an increased odds of EVO (odds ratio: 1.03, 95% confidence interval: 1.01-1.06). However, no other baseline characteristics were significantly associated the odds of EVO.
CONCLUSIONS: Our study reveals the effectiveness of head rotation and OA in reducing EVO and improving mouth breathing in OSA patients, offering valuable insights for future treatment strategies.
METHODS: Case series.
METHODS: Tertiary Medical Center.
METHODS: Seventy-two OSA patients underwent clinical evaluation, polysomnography, and DISE, utilizing interventions like intraoral negative airway pressure (iNAP), mouth closure, and oral appliances (OAs) in supine positions with head rotation. The findings, classified under velopharynx, oropharynx, tongue base, epiglottis, included the presence of EVO.
RESULTS: The results demonstrated that interventions including mouth closure and iNAP were associated with increased observation of EVO (43.1% and 34.7%) compared to OA (20.1%). However, head rotation was associated with decreased presence of EVO during DISE compare to supine (26% vs 35.8%). Noticeably, per 1 year increase of age was associated with an increased odds of EVO (odds ratio: 1.03, 95% confidence interval: 1.01-1.06). However, no other baseline characteristics were significantly associated the odds of EVO.
CONCLUSIONS: Our study reveals the effectiveness of head rotation and OA in reducing EVO and improving mouth breathing in OSA patients, offering valuable insights for future treatment strategies.
摘要：
目的：阻塞性睡眠呼吸暂停（OSA）是一种普遍的疾病，口腔呼吸影响其严重程度。呼气喉部梗阻(EVO),在药物诱导的睡眠内窥镜检查（DISE）期间观察到，可能有助于OSA患者的口腔呼吸。EVO在呼气期间导致咽部和鼻腔之间的阻塞。本研究旨在确定DISE期间与EVO阳性相关的因素。
方法：案例系列。
方法：三级医疗中心.
方法：72例OSA患者接受临床评估，多导睡眠图,DISE,利用口内气道负压(iNAP)等干预措施，封口,和头部旋转的仰卧位口腔矫治器（OAs）。调查结果,归类为velopharynx，口咽,舌根,会厌,包括EVO的存在。
结果：结果表明，与OA（20.1％）相比，包括封口和iNAP在内的干预措施与EVO（43.1％和34.7％）的观察增加有关。然而,与仰卧位相比,DISE期间头部旋转与EVO减少相关(26%vs35.8%).值得注意的是，年龄每增加1年与EVO的几率增加相关(比值比:1.03,95%置信区间:1.01~1.06).然而,没有其他基线特征与EVO的几率显著相关.
结论：我们的研究揭示了头部旋转和OA在减少OSA患者的EVO和改善口腔呼吸方面的有效性，为未来的治疗策略提供有价值的见解。
方法：案例系列。
方法：三级医疗中心.
方法：72例OSA患者接受临床评估，多导睡眠图,DISE,利用口内气道负压(iNAP)等干预措施，封口,和头部旋转的仰卧位口腔矫治器（OAs）。调查结果,归类为velopharynx，口咽,舌根,会厌,包括EVO的存在。
结果：结果表明，与OA（20.1％）相比，包括封口和iNAP在内的干预措施与EVO（43.1％和34.7％）的观察增加有关。然而,与仰卧位相比,DISE期间头部旋转与EVO减少相关(26%vs35.8%).值得注意的是，年龄每增加1年与EVO的几率增加相关(比值比:1.03,95%置信区间:1.01~1.06).然而,没有其他基线特征与EVO的几率显著相关.
结论：我们的研究揭示了头部旋转和OA在减少OSA患者的EVO和改善口腔呼吸方面的有效性，为未来的治疗策略提供有价值的见解。
