Diagnostic value of transnasal fibrolaryngoscopy with a Muller test in the choice of treatment techniques in a patient with moderate ronchopathy and obstructive sleep apnea syndrome: A clinical case

Abstract

Despite the wide variety of conservative and surgical methods of treatment of obstructive sleep apnea syndrome, choosing therapeutic techniques in affected patients remains relevant. Diagnosis of the level and degree of obstruction of the upper respiratory tract can be carried out by endoscopic examination in both the waking state and during drug-induced sleep. Considering that most patients with obstructive sleep apnea syndrome are older people with a burdened somatic history, with high anesthesiological risk, thorough examination is necessary for the selection of optimal treatment techniques. The article presents in detail the choice and justification of therapeutic techniques in a patient with moderate snoring and obstructive sleep apnea syndrome.

Keywords

obstructive sleep apnea syndrome / Muller test / endoscopy during drug-induced sleep

References

[1] Uryas’ev OM, Zhukova LA, Glotov SI, et al. Bilateral diaphragm paralysis: a clinical case Pul’monologiya. 2022;32(6):906–914. EDN: MXODZQ doi: 10.18093/0869-0189-2022-32-6-906-914

[2] Урясьев О.М., Жукова Л.А., Глотов С.И., и др. Двусторонний паралич диафрагмы: клиническое наблюдение // Пульмонология. 2022. Т. 32, № 6. С. 906–914. EDN: MXODZQ doi: 10.18093/0869-0189-2022-32-6-906-914

[3] Kapustina NA, Kolosov AA. Correlation between respiratory muscle disturbance and airway hyperreactivity in patients with chronic non obstructive bronchitis and chronic obstructive pulmonary disease. Bulletin physiology and pathology of respiration. 2006;22:67–72. EDN: HSMDBD

[4] Капустина Н.А., Колосов А.А. Взаимосвязь нарушений функционального состояния дыхательных мышц и гиперреактивности дыхательных путей у больных хроническим необструктивным бронхитом и хронической обструктивной болезнью легких // Бюллетень физиологии и патологии дыхания. 2006. № 22. С. 67–72. EDN: HSMDBD

[5] Gottlieb DJ, Punjabi NM. Diagnosis and management of obstructive sleep apnea: a review. JAMA. 2020;323(14):1389–1400. doi: 10.1001/jama.2020.3514

[6] Gottlieb D.J., Punjabi N.M. Diagnosis and management of obstructive sleep apnea: a review // JAMA. 2020. Vol. 323, N 14. P. 1389–1400. doi: 10.1001/jama.2020.3514

[7] Ryabova MA, Faizova AR, Volchkov EA. Long-term results after laser-assisted non-resectionary uvulopalatoplasty. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae. 2023;29(1):28–34. EDN: BPDDXM doi: 10.33848/foliorl23103825-2023-29-1-28-34

[8] Рябова М.А., Фаизова А.Р., Волчков Е.А. Отсроченные результаты после лазерной нерезекционной увулопалатопластики // Folia Otorhinolaryngologiae et Pathologiae Respiratoriae. 2023. Т. 29, № 1. С. 28–34. EDN: BPDDXM doi: 10.33848/foliorl23103825-2023-29-1-28-34

[9] Karpishchenko S, Aleksandrov A, Sopko O, et al. Conservative therapy for snoring and obstructive sleep apnea syndrome. Vrach. 2016;2:17–19. EDN: VQZUHZ

[10] Карпищенко С., Александров А., Сопко О., и др. Консервативная терапия храпа и синдрома обструктивного апноэ во сне // Врач. 2016. № 2. С. 17–19. EDN: VQZUHZ

[11] Kolyadich ZhV. The analysis of diagnostic significance of upper airways endoscopy in patients with obstructive sleep apnea syndrome. Rossijskaya otorinolaringologiya. 2014;(6(73)):57–61. EDN: TFFXLV

[12] Колядич Ж.В. Анализ диагностической значимости эндоскопического исследования верхних дыхательных путей у пациентов с синдромом обструктивного апноэ во сне // Российская оториноларингология. 2014. № 6(73). С. 57–61. EDN: TFFXLV

[13] Zerpa Zerpa V, Carrasco Llatas M, Agostini Porras G, Dalmau Galofre J. Drug-induced sedation endoscopy versus clinical exploration for the diagnosis of severe upper airway obstruction in OSAHS patients. Sleep Breath. 2015;19(4):1367–1372. doi: 10.1007/s11325-015-1266-z

[14] Zerpa Zerpa V., Carrasco Llatas M., Agostini Porras G., Dalmau Galofre J. Drug-induced sedation endoscopy versus clinical exploration for the diagnosis of severe upper airway obstruction in OSAHS patients // Sleep Breath. 2015. Vol. 19, N 4. P. 1367–1372. doi: 10.1007/s11325-015-1266-z

[15] Soares D, Folbe AJ, Yoo G, et al. Drug-induced sleep endoscopy vs awake Müller’s maneuver in the diagnosis of severe upper airway obstruction. Otolaryngol Head Neck Surg. 2013;148(1):151–156. doi: 10.1177/0194599812460505

[16] Soares D., Folbe A.J., Yoo G., et al. Drug-induced sleep endoscopy vs awake Müller’s maneuver in the diagnosis of severe upper airway obstruction // Otolaryngol Head Neck Surg. 2013. Vol. 148, N 1. P. 151–156. doi: 10.1177/0194599812460505

[17] Van den Bossche K, Van de Perck E, Wellman A, et al. Comparison of drug-induced sleep endoscopy and natural sleep endoscopy in the assessment of upper airway pathophysiology during sleep: protocol and study design. Front Neurol. 2021;12:768973. doi: 10.3389/fneur.2021.768973

[18] Van den Bossche K., Van de Perck E., Wellman A., et al. Comparison of drug-induced sleep endoscopy and natural sleep endoscopy in the assessment of upper airway pathophysiology during sleep: protocol and study design // Front Neurol. 2021. Vol. 12. P. 768973. doi: 10.3389/fneur.2021.768973

[19] Kezirian EJ, Hohenhorst W, De Vries N. Drug-induced sleep endoscopy: the VOTE classification. Eur Arch Otorhinolaryngol. 2011;268:1233–1236. doi: 10.1007/s00405-011-1633-8

[20] Kezirian E.J., Hohenhorst W., De Vries N. Drug-induced sleep endoscopy: the VOTE classification // Eur Arch Otorhinolaryngol. 2011. Vol. 268. P. 1233–1236. doi: 10.1007/s00405-011-1633-8

[21] Kolyadich ZhV, Kalinkin AL. Obstructive sleep apnea syndrome: the view of an otorhinolaryngologist and sleep specialist. Therapy. 2016;1(5):42–50. EDN: VZLIJP

[22] Колядич Ж.В., Калинкин А.Л. Синдром обструктивного апноэ сна: взгляд оториноларинголога и сомнолога // Терапия. 2016. № 1(5). С. 42–50. EDN: VZLIJP

[23] Wang WM, Hsu YB, Lan MY, et al. The relationship between modified mallampati score, müller’s maneuver and drug-induced sleep endoscopy regarding retrolingual obstruction. Ann Otol Rhinol Laryngol. 2018;127(7):463–469. doi: 10.1177/0003489418778302

[24] Wang W.M., Hsu Y.B., Lan M.Y., et al. The relationship between modified mallampati score, müller’s maneuver and drug-induced sleep endoscopy regarding retrolingual obstruction // Ann Otol Rhinol Laryngol. 2018. Vol. 127, N 7. P. 463–469. doi: 10.1177/0003489418778302

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