Upper airway assessment in obstructive sleep apnea patients: can computed tomography with lateral cephalometry replace drug-induced sleep endoscopy (DISE)?

IF 0.9 Q3 OTORHINOLARYNGOLOGY
Ana Campos , Pedro Cebola , Sara Simões Dias , José Pedro Pais , Susana Sousa , Sérgio Cardoso , João Paço , Cristina Caroça
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Abstract

Objective

To evaluate the association between results from drug-induced sleep endoscopy (DISE) and computed tomography with lateral cephalometry (CTLC) of the pharynx in obstructive sleep apnea (OSA) patients, regarding the same anatomic level, in order to understand if CTLC could replace DISE in selected patients.

Study design

Cross-sectional.

Setting

Tertiary hospital.

Methods

A total of 71 patients who attended the Sleep Medicine Consultation in the Otorhinolaryngology Department of Hospital CUF Tejo between 1.6.2019 and 30.9.2021, performed a polysomnographic sleep study and were elected to undergo DISE and CTLC of the pharynx for diagnostic purposes were selected. Obstructions at the same anatomic levels – tongue base, epiglottis and velum - were compared in both exams.

Results

Patients with reduction of epiglottis-pharynx space on CTLC had also a complete obstruction at epiglottis level on the VOTE classification of DISE (p = 0,027). Reduction of velum-pharynx space or tongue base-pharynx space were not related to complete obstruction of the velum (P = 0,623) or the tongue base (p = 0,594) found in DISE. Those with two or more space reductions had a tendency to multilevel obstruction observed in DISE (p = 0.089).

Conclusion

When evaluating the obstruction level(s) of an OSA patient, efforts should be made to perform DISE, since CTLC measures, though regarding at the same structures, don´t correlate completely with obstructions observed in DISE.

阻塞性睡眠呼吸暂停患者的上呼吸道评估:计算机断层扫描与侧位头测量术能否取代药物诱导睡眠内窥镜(DISE)?
目的在相同的解剖水平上,评估阻塞性睡眠呼吸暂停(OSA)患者药物诱导睡眠内窥镜(DISE)和咽侧头影计算机断层扫描(CTLC)结果之间的相关性,以了解CTLC是否可以取代选定患者的DISE。研究设计跨学科设置三级医院。方法选择在2019年6月1日至2021年9月30日期间参加了CUF Tejo医院耳鼻咽喉科睡眠医学咨询的71名患者,进行了多导睡眠图研究,并选择他们进行了DISE和咽CTLC诊断。在两次检查中,对相同解剖水平(舌根、会厌和硬脑膜)的梗阻进行了比较。结果CTLC会厌咽间隙缩小的患者在DISE的VOTE分级上也有会厌水平的完全阻塞(p = 0027)。咽膜间隙缩小或舌基咽间隙缩小与咽膜完全阻塞无关(P = 0623)或舌根(p = 0594)。有两次或两次以上空间缩小的患者在DISE中有多级阻塞的趋势(p = 0.089)。结论在评估OSA患者的阻塞程度时,应努力进行DISE,因为CTLC测量虽然涉及相同的结构,但与DISE中观察到的阻塞并不完全相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.40
自引率
20.00%
发文量
44
审稿时长
44 days
期刊介绍: Es la revista más importante en español dedicada a la especialidad. Ofrece progresos científicos y técnicos tanto a nivel de originales como de casos clínicos. Además, es la Publicación Oficial de la Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial y está presente en los más prestigiosos índices de referencia.
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