Novel Grading System for Quantifying Upper-Airway Obstruction on Sleep Endoscopy
Background The aim of this study was to present a novel anatomically comprehensive and clinically applicable system for the quantification of sleep endoscopy findings in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods Fifty-five adult patients with a polysomnographic diagnos...
Gespeichert in:
| Veröffentlicht in: | Lung 2012-06, Vol.190 (3), p.313-318 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 318 |
|---|---|
| container_issue | 3 |
| container_start_page | 313 |
| container_title | Lung |
| container_volume | 190 |
| creator | Bachar, Gideon Nageris, Benny Feinmesser, Raphael Hadar, Tuvia Yaniv, Eitan Shpitzer, Thomas Eidelman, Leonid |
| description | Background
The aim of this study was to present a novel anatomically comprehensive and clinically applicable system for the quantification of sleep endoscopy findings in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).
Methods
Fifty-five adult patients with a polysomnographic diagnosis of OSAHS were referred for midazolam-induced sleep endoscopy following failure of continuous positive airway pressure. Five anatomical sites of possible obstruction along the upper airway were documented: nose/nasopharynx (N), uvulopalatine plane (P), tongue base (T), larynx (L), and hypopharynx (H). Each involved site was assigned a severity grade of 1 (partial obstruction) or 2 (complete obstruction). The digits representing the obstruction pattern at each level were then added to yield a severity index (SI). The SI for each patient was determined by two independent observers. Findings were correlated with the respiratory disturbance index (RDI) and body mass index (BMI).
Results
The SI was significantly correlated with the RDI (
R
= 0.746, Pearson;
P
|
| doi_str_mv | 10.1007/s00408-011-9367-3 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1010489465</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A331348839</galeid><sourcerecordid>A331348839</sourcerecordid><originalsourceid>FETCH-LOGICAL-c508t-ffde32d99d007a633f23fe7b5ed237331ea386f4c32225b930257a0ce1cc660a3</originalsourceid><addsrcrecordid>eNp1kl9rFDEUxYModq1-AF9kQBBf0ubPzGTmcSltFYqt1D6HbOZmm5JJxmTGMt_ejFu1lZUEAje_c7j3chB6S8kRJUQcJ0JK0mBCKW55LTB_hla05AxTUZHnaEV4STHLzAF6ldIdIVTUtHqJDhhjVVMyukJXX8IPcMV5VJ312-J6TiP0hQmx-DopP1ozL-WbYYCI1zbeq7m43KQxTnq0wRf5XjuAoTj1XUg6DPNr9MIol-DNw3uIbs5Ov518wheX559P1hdYV6QZsTEdcNa1bZcHUTXnhnEDYlNBx7jgnILiTW1KzZdeNy0nrBKKaKBa1zVR_BB93PkOMXyfII2yt0mDc8pDmJKkhJKyacu6yuj7f9C7MEWfu_tFESFow_5SW-VAWm_CGJVeTOU698PLpuFtpvAeagseonLBg7G5_IQ_2sPn00Fv9V7Bh0eCW1BuvE3BTcu601OQ7kAdQ0oRjByi7VWc81BymUru4iFzPOQSD8mz5t3DJqZND90fxe88ZIDtgJS__Bbi41X9z_Un2VXA6g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1010077182</pqid></control><display><type>article</type><title>Novel Grading System for Quantifying Upper-Airway Obstruction on Sleep Endoscopy</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Bachar, Gideon ; Nageris, Benny ; Feinmesser, Raphael ; Hadar, Tuvia ; Yaniv, Eitan ; Shpitzer, Thomas ; Eidelman, Leonid</creator><creatorcontrib>Bachar, Gideon ; Nageris, Benny ; Feinmesser, Raphael ; Hadar, Tuvia ; Yaniv, Eitan ; Shpitzer, Thomas ; Eidelman, Leonid</creatorcontrib><description>Background
The aim of this study was to present a novel anatomically comprehensive and clinically applicable system for the quantification of sleep endoscopy findings in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).
Methods
Fifty-five adult patients with a polysomnographic diagnosis of OSAHS were referred for midazolam-induced sleep endoscopy following failure of continuous positive airway pressure. Five anatomical sites of possible obstruction along the upper airway were documented: nose/nasopharynx (N), uvulopalatine plane (P), tongue base (T), larynx (L), and hypopharynx (H). Each involved site was assigned a severity grade of 1 (partial obstruction) or 2 (complete obstruction). The digits representing the obstruction pattern at each level were then added to yield a severity index (SI). The SI for each patient was determined by two independent observers. Findings were correlated with the respiratory disturbance index (RDI) and body mass index (BMI).
Results
The SI was significantly correlated with the RDI (
R
= 0.746, Pearson;
P
< 0.0001) and predicted disease severity with 65% accuracy. There was no association with BMI. By site, the tongue base and hypopharynx were significantly correlated with obstruction severity; obstruction in the tongue base predicted disease severity with a sensitivity of 68.8 and sensitivity of 81.1.
Conclusion
Our easy-to-use endoscopic grading system provides physicians with an accurate picture of the pattern of the upper-airway system obstruction in patients with obstructive sleep apnea/hypopnea syndrome. It is a promising tool for estimating the location and severity of upper airway disease and may have implications for treatment planning.</description><identifier>ISSN: 0341-2040</identifier><identifier>EISSN: 1432-1750</identifier><identifier>DOI: 10.1007/s00408-011-9367-3</identifier><identifier>PMID: 22258421</identifier><identifier>CODEN: LUNGD9</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Adult ; Airway management ; Airway obstruction (Medicine) ; Airway Obstruction - pathology ; Body Mass Index ; Chi-Square Distribution ; Endoscopic surgery ; Endoscopy ; Female ; Humans ; Hypopharynx - pathology ; Larynx - pathology ; Male ; Medical procedures ; Medicine ; Medicine & Public Health ; Middle Aged ; Nasopharynx - pathology ; Palatine Tonsil - pathology ; Pathology ; Physiology ; Pneumology/Respiratory System ; Severity of Illness Index ; Sleep ; Sleep apnea ; Sleep Apnea, Obstructive - pathology ; Tongue - pathology ; Uvula - pathology</subject><ispartof>Lung, 2012-06, Vol.190 (3), p.313-318</ispartof><rights>Springer Science+Business Media, LLC 2012</rights><rights>COPYRIGHT 2012 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c508t-ffde32d99d007a633f23fe7b5ed237331ea386f4c32225b930257a0ce1cc660a3</citedby><cites>FETCH-LOGICAL-c508t-ffde32d99d007a633f23fe7b5ed237331ea386f4c32225b930257a0ce1cc660a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00408-011-9367-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00408-011-9367-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22258421$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bachar, Gideon</creatorcontrib><creatorcontrib>Nageris, Benny</creatorcontrib><creatorcontrib>Feinmesser, Raphael</creatorcontrib><creatorcontrib>Hadar, Tuvia</creatorcontrib><creatorcontrib>Yaniv, Eitan</creatorcontrib><creatorcontrib>Shpitzer, Thomas</creatorcontrib><creatorcontrib>Eidelman, Leonid</creatorcontrib><title>Novel Grading System for Quantifying Upper-Airway Obstruction on Sleep Endoscopy</title><title>Lung</title><addtitle>Lung</addtitle><addtitle>Lung</addtitle><description>Background
The aim of this study was to present a novel anatomically comprehensive and clinically applicable system for the quantification of sleep endoscopy findings in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).
Methods
Fifty-five adult patients with a polysomnographic diagnosis of OSAHS were referred for midazolam-induced sleep endoscopy following failure of continuous positive airway pressure. Five anatomical sites of possible obstruction along the upper airway were documented: nose/nasopharynx (N), uvulopalatine plane (P), tongue base (T), larynx (L), and hypopharynx (H). Each involved site was assigned a severity grade of 1 (partial obstruction) or 2 (complete obstruction). The digits representing the obstruction pattern at each level were then added to yield a severity index (SI). The SI for each patient was determined by two independent observers. Findings were correlated with the respiratory disturbance index (RDI) and body mass index (BMI).
Results
The SI was significantly correlated with the RDI (
R
= 0.746, Pearson;
P
< 0.0001) and predicted disease severity with 65% accuracy. There was no association with BMI. By site, the tongue base and hypopharynx were significantly correlated with obstruction severity; obstruction in the tongue base predicted disease severity with a sensitivity of 68.8 and sensitivity of 81.1.
Conclusion
Our easy-to-use endoscopic grading system provides physicians with an accurate picture of the pattern of the upper-airway system obstruction in patients with obstructive sleep apnea/hypopnea syndrome. It is a promising tool for estimating the location and severity of upper airway disease and may have implications for treatment planning.</description><subject>Adult</subject><subject>Airway management</subject><subject>Airway obstruction (Medicine)</subject><subject>Airway Obstruction - pathology</subject><subject>Body Mass Index</subject><subject>Chi-Square Distribution</subject><subject>Endoscopic surgery</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Humans</subject><subject>Hypopharynx - pathology</subject><subject>Larynx - pathology</subject><subject>Male</subject><subject>Medical procedures</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nasopharynx - pathology</subject><subject>Palatine Tonsil - pathology</subject><subject>Pathology</subject><subject>Physiology</subject><subject>Pneumology/Respiratory System</subject><subject>Severity of Illness Index</subject><subject>Sleep</subject><subject>Sleep apnea</subject><subject>Sleep Apnea, Obstructive - pathology</subject><subject>Tongue - pathology</subject><subject>Uvula - pathology</subject><issn>0341-2040</issn><issn>1432-1750</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kl9rFDEUxYModq1-AF9kQBBf0ubPzGTmcSltFYqt1D6HbOZmm5JJxmTGMt_ejFu1lZUEAje_c7j3chB6S8kRJUQcJ0JK0mBCKW55LTB_hla05AxTUZHnaEV4STHLzAF6ldIdIVTUtHqJDhhjVVMyukJXX8IPcMV5VJ312-J6TiP0hQmx-DopP1ozL-WbYYCI1zbeq7m43KQxTnq0wRf5XjuAoTj1XUg6DPNr9MIol-DNw3uIbs5Ov518wheX559P1hdYV6QZsTEdcNa1bZcHUTXnhnEDYlNBx7jgnILiTW1KzZdeNy0nrBKKaKBa1zVR_BB93PkOMXyfII2yt0mDc8pDmJKkhJKyacu6yuj7f9C7MEWfu_tFESFow_5SW-VAWm_CGJVeTOU698PLpuFtpvAeagseonLBg7G5_IQ_2sPn00Fv9V7Bh0eCW1BuvE3BTcu601OQ7kAdQ0oRjByi7VWc81BymUru4iFzPOQSD8mz5t3DJqZND90fxe88ZIDtgJS__Bbi41X9z_Un2VXA6g</recordid><startdate>20120601</startdate><enddate>20120601</enddate><creator>Bachar, Gideon</creator><creator>Nageris, Benny</creator><creator>Feinmesser, Raphael</creator><creator>Hadar, Tuvia</creator><creator>Yaniv, Eitan</creator><creator>Shpitzer, Thomas</creator><creator>Eidelman, Leonid</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120601</creationdate><title>Novel Grading System for Quantifying Upper-Airway Obstruction on Sleep Endoscopy</title><author>Bachar, Gideon ; Nageris, Benny ; Feinmesser, Raphael ; Hadar, Tuvia ; Yaniv, Eitan ; Shpitzer, Thomas ; Eidelman, Leonid</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c508t-ffde32d99d007a633f23fe7b5ed237331ea386f4c32225b930257a0ce1cc660a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Airway management</topic><topic>Airway obstruction (Medicine)</topic><topic>Airway Obstruction - pathology</topic><topic>Body Mass Index</topic><topic>Chi-Square Distribution</topic><topic>Endoscopic surgery</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Humans</topic><topic>Hypopharynx - pathology</topic><topic>Larynx - pathology</topic><topic>Male</topic><topic>Medical procedures</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nasopharynx - pathology</topic><topic>Palatine Tonsil - pathology</topic><topic>Pathology</topic><topic>Physiology</topic><topic>Pneumology/Respiratory System</topic><topic>Severity of Illness Index</topic><topic>Sleep</topic><topic>Sleep apnea</topic><topic>Sleep Apnea, Obstructive - pathology</topic><topic>Tongue - pathology</topic><topic>Uvula - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bachar, Gideon</creatorcontrib><creatorcontrib>Nageris, Benny</creatorcontrib><creatorcontrib>Feinmesser, Raphael</creatorcontrib><creatorcontrib>Hadar, Tuvia</creatorcontrib><creatorcontrib>Yaniv, Eitan</creatorcontrib><creatorcontrib>Shpitzer, Thomas</creatorcontrib><creatorcontrib>Eidelman, Leonid</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Lung</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bachar, Gideon</au><au>Nageris, Benny</au><au>Feinmesser, Raphael</au><au>Hadar, Tuvia</au><au>Yaniv, Eitan</au><au>Shpitzer, Thomas</au><au>Eidelman, Leonid</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Novel Grading System for Quantifying Upper-Airway Obstruction on Sleep Endoscopy</atitle><jtitle>Lung</jtitle><stitle>Lung</stitle><addtitle>Lung</addtitle><date>2012-06-01</date><risdate>2012</risdate><volume>190</volume><issue>3</issue><spage>313</spage><epage>318</epage><pages>313-318</pages><issn>0341-2040</issn><eissn>1432-1750</eissn><coden>LUNGD9</coden><abstract>Background
The aim of this study was to present a novel anatomically comprehensive and clinically applicable system for the quantification of sleep endoscopy findings in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).
Methods
Fifty-five adult patients with a polysomnographic diagnosis of OSAHS were referred for midazolam-induced sleep endoscopy following failure of continuous positive airway pressure. Five anatomical sites of possible obstruction along the upper airway were documented: nose/nasopharynx (N), uvulopalatine plane (P), tongue base (T), larynx (L), and hypopharynx (H). Each involved site was assigned a severity grade of 1 (partial obstruction) or 2 (complete obstruction). The digits representing the obstruction pattern at each level were then added to yield a severity index (SI). The SI for each patient was determined by two independent observers. Findings were correlated with the respiratory disturbance index (RDI) and body mass index (BMI).
Results
The SI was significantly correlated with the RDI (
R
= 0.746, Pearson;
P
< 0.0001) and predicted disease severity with 65% accuracy. There was no association with BMI. By site, the tongue base and hypopharynx were significantly correlated with obstruction severity; obstruction in the tongue base predicted disease severity with a sensitivity of 68.8 and sensitivity of 81.1.
Conclusion
Our easy-to-use endoscopic grading system provides physicians with an accurate picture of the pattern of the upper-airway system obstruction in patients with obstructive sleep apnea/hypopnea syndrome. It is a promising tool for estimating the location and severity of upper airway disease and may have implications for treatment planning.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>22258421</pmid><doi>10.1007/s00408-011-9367-3</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0341-2040 |
| ispartof | Lung, 2012-06, Vol.190 (3), p.313-318 |
| issn | 0341-2040 1432-1750 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1010489465 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Adult Airway management Airway obstruction (Medicine) Airway Obstruction - pathology Body Mass Index Chi-Square Distribution Endoscopic surgery Endoscopy Female Humans Hypopharynx - pathology Larynx - pathology Male Medical procedures Medicine Medicine & Public Health Middle Aged Nasopharynx - pathology Palatine Tonsil - pathology Pathology Physiology Pneumology/Respiratory System Severity of Illness Index Sleep Sleep apnea Sleep Apnea, Obstructive - pathology Tongue - pathology Uvula - pathology |
| title | Novel Grading System for Quantifying Upper-Airway Obstruction on Sleep Endoscopy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T18%3A10%3A02IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Novel%20Grading%20System%20for%20Quantifying%20Upper-Airway%20Obstruction%20on%20Sleep%20Endoscopy&rft.jtitle=Lung&rft.au=Bachar,%20Gideon&rft.date=2012-06-01&rft.volume=190&rft.issue=3&rft.spage=313&rft.epage=318&rft.pages=313-318&rft.issn=0341-2040&rft.eissn=1432-1750&rft.coden=LUNGD9&rft_id=info:doi/10.1007/s00408-011-9367-3&rft_dat=%3Cgale_proqu%3EA331348839%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1010077182&rft_id=info:pmid/22258421&rft_galeid=A331348839&rfr_iscdi=true |