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

문지승; 구수권; 김영중; 이상훈; 이호병; 박근형; 이상준

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자료유형: 학술저널

저자정보: 문지승 구수권 김영중 이상훈 이호병 박근형 이상준

저널정보: 대한이비인후과학회 부산,울산,경남 지부회 임상이비인후과 임상이비인후과 제29권 제2호

발행연도: 2018.1

수록면: 190 - 197 (8page)

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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.

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