Novel Grading System for Quantifying Upper-Airway Obstruction on Sleep Endoscopy

Bachar, Gideon; Nageris, Ben I.; Feinmesser, Raphael; Hadar, Tuvia; Yaniv, Eitan; Shpitzer, Thomas; Eidelman, Leonid A.

doi:10.1007/s00408-011-9367-3

Cited by 67 publications

(54 citation statements)

References 16 publications

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“…We placed the NPT tip slightly beyond the free edge of the soft palate and repeated PSG measurements to examine airway obstruction in and below the glossopharyngeal area. This examination was conducted during an entire night of natural sleep, so the reliability of this method should be better than that of common diagnostic methods such as routine physical examination, electronic endoscopy, CT imaging in the awake state, or endoscopic and imaging airway examinations during sedative‐induced sleep . Continuous airway pressure measurement or measurements with the AG200 localization diagnostic system was conducted over a night of natural sleep, but special equipment was needed …”

Section: Discussionmentioning

confidence: 99%

The nasopharyngeal tube: A simple and effective tool to indicate the need for uvulopalatopharyngoplasty

Bao³

et al. 2013

The Laryngoscope

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Section: Discussionmentioning

confidence: 99%

The nasopharyngeal tube: A simple and effective tool to indicate the need for uvulopalatopharyngoplasty

Bao³

et al. 2013

The Laryngoscope

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“…It is not known whether these factors affect the success rate of surgery, and further research is necessary to elucidate the effect of lateral pharyngeal wall or epiglottic obstruction in OSA. Two out of the 19 studies classified the obstruction site into three levels (soft palate, tongue base, and epiglottis); these studies could not be encompassed in the meta‐analysis of the two‐level or four‐level systems . However, they were included in the present study because they also provided detailed data on the obstruction site.…”

Section: Discussionmentioning

confidence: 99%

Meta‐Analysis of Obstruction Site Observed With Drug‐Induced Sleep Endoscopy in Patients With Obstructive Sleep Apnea

Lee

Cho

2018

The Laryngoscope

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Objective To perform a meta‐analysis on the distribution and characteristics of the obstructive site in patients with obstructive sleep apnea (OSA) using data from a variety of published studies that evaluated the obstruction with drug‐induced sleep endoscopy (DISE). Methods A literature search was performed to identify studies in which DISE was used to identify the obstruction site in adult patients with OSA, and the obstruction site was described in sufficient detail. Four items were evaluated in the meta‐analysis: the obstruction site, closing direction of the soft palate, degree of closure, and percentage of single‐level obstructions. Results A total of 2,950 patients from 19 studies were included. In the two‐level classification system, the rate of obstruction was 91.6% for the soft palate and 58.0% for the tongue base. In the four‐level classification system, the rate of obstruction was 84.1% for soft palate, 32.8% for the tonsil, 51.6% for the tongue base, and 34.3% for the epiglottis. The soft palate closed in the anteroposterior direction at a rate of 44.4% and in the concentric direction at a rate of 46.5%. The rate of a closure of 75% or more was 69.3% for the soft palate and 56.8% for the hypopharynx. The percentage of single‐level obstructions was 42.5%. Conclusion The soft palate is obstructed in most patients with OSA, and the tongue base is obstructed in half of the patients. In addition, multilevel obstructions including the tonsil, lateral pharyngeal wall, or epiglottis are common; thus, these areas must be checked carefully. Level of Evidence NA Laryngoscope, 129:1235–1243, 2019

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“…Additionally, possible laryngeal obstruction can be graded as positive/ negative and supraglottic/glottic. Bachar et al [41] recently introduced a novel grading system which allows the user to document collapsibility of the upper airway based on five possible anatomical sites: (1) nose and nasopharynx, (2) palatine plane, uvula and tonsils, (3) tongue base, (4) larynx, and (5) hypopharynx. Obstructions can be categorized as being complete (defined as complete blockage of the airway passage for at least 10 s) or partial (defined as narrowing or intermittent collapse).…”

Section: Discussionmentioning

confidence: 99%

The Utility of Sleep Endoscopy in Adults with Obstructive Sleep Apnea: A Review of the Literature

Maanen

Ravesloot

Safiruddin

et al. 2013

Curr Otorhinolaryngol Rep

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Since history and physical examination alone cannot reliably diagnose obstructive sleep apnea (OSA), the gold standard for the diagnosis of OSA is polysomnography. When an oral device or surgery is considered, it is of utmost importance to examine an individual's pattern, degree and site(s) of upper airway obstruction. This article tries to evaluate recent literature published on the use of (drug-induced) sleep endoscopy in evaluating the individually tailored treatment. Different techniques, interrater reliability, test-retest reliability and currently available data on the relationship with treatment outcome are reviewed.

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Novel Grading System for Quantifying Upper-Airway Obstruction on Sleep Endoscopy

Cited by 67 publications

References 16 publications

The nasopharyngeal tube: A simple and effective tool to indicate the need for uvulopalatopharyngoplasty

The nasopharyngeal tube: A simple and effective tool to indicate the need for uvulopalatopharyngoplasty

Meta‐Analysis of Obstruction Site Observed With Drug‐Induced Sleep Endoscopy in Patients With Obstructive Sleep Apnea

The Utility of Sleep Endoscopy in Adults with Obstructive Sleep Apnea: A Review of the Literature

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