Tevfik Metin Onerci | PubMed Health

PubMed2006

Comparison of two endoscopic examination methods, the Muller maneuver and fiberoptic pharyngoscopy during sleep, in patients with obstructive sleep apnea.

OBJECTIVES: This study was designed to compare two endoscopic examination methods, the Muller maneuver (MM) and fiberoptic pharyngoscopy during sleep, both of which are used to detect obstructed segments in patients with obstructive sleep apnea. PATIENTS AND METHODS: The study included 28 patients (23 males, 5 females; mean age 44.6 years; range 28 to 59 years) who underwent uvulopalatopharyngoplasty (UPPP) for snoring or obstructive sleep apnea. Obstruction was examined both at the level of the soft palate and tongue base while the patients were awake and asleep and was scored. The Muller maneuver was performed in the sitting and supine positions. In addition, fiberoptic pharyngoscopy was performed right after induction of anesthesia. The results of the two methods were compared. RESULTS: Changes in body position were not associated with significant differences in the results of MM. The two methods were found to be highly discordant, in that a greater degree of obstruction was noted especially at the level of the soft palate by fiberoptic pharyngoscopy. CONCLUSION: It was concluded that the degree of obstruction might be underestimated by MM.

Adult↗

PubMed2005

Body fat composition: a predictive factor for obstructive sleep apnea.

OBJECTIVE: To investigate body fat composition, measured by bioelectrical impedance assay (BIA), for predicting the presence and severity of obstructive sleep apnea-hypopnea syndrome (OSAHS). Body fat composition was also compared with other well-known OSAHS predictors such as body mass index (BMI), neck circumference, and abdominal visceral fat. STUDY DESIGN: A prospective study was designed. Fifty-one patients (41 male, 10 female), who were referred to Hacettepe University Faculty of Medicine, Department of Otorhinolaryngology, Head and Neck Surgery with suspected OSAHS, between April 2003 and June 2004, were included in the study. METHODS: All patients underwent polysomnography (PSG) and were classified according to their apnea-hypopnea index (AHI) into four groups. The cross-sectional area of abdominal visceral fat was measured by computed tomography (CT) scanning in 33 of the patients. Neck circumference and BMI was measured for all patients. BIA was performed to determine body fat composition. The groups were compared, and correlation of the variables with AHI was investigated. RESULTS: Of the variables, BMI and percentage of body fat (determined by BIA) were found to be significantly correlated with AHI (r = 0.782, r = 0.647). CT of cross-sectional area of abdominal visceral fat provided 100% sensitivity and specificity (P < .001) in differentiating simple snorers from OSAHS patients. By combining percentage of body fat and body fat mass, higher levels of sensitivity (95%) and specificity (100%) were achieved for diagnosis of OSAHS. CONCLUSION: It was concluded that the BIA could be an inexpensive and practical alternative to prePSG screening tests and should be included in the evaluation of OSAHS patients.

Adult↗