3. ELALUATION OF THE ROLE OF MULLER’S MANEUVER IN DIAGNOSING THE SITE OF UPPER AIRWAY OBSTRUCTION IN SLEEP APNEA/ SNORING SYNDROME

Dao Dinh Thi1, Nguyen Trung Hieu2, Nguyen Tuan Son3, Nguyen Quang Hung4
1 ational Otorhinolaryngology Hospital
2 Hanoi Medical University
3 University of Medicine and Pharmacy, Vietnam National University, Hanoi
4 Viet Tiep Friendship Hospital

Main Article Content

Abstract

apnea condition.


Subjects and methods: The research involved 34 patients seeking surgical intervention for snoring at the National Otorhinolaryngology Hospital from January 2024 to September 2024.


Results: Features of the upper airway obstruction's location: only 20.6% of cases with turbinate hypertrophy, 14.7% with deviated septum, 17.6% with long and broad uvula, 13.5% with hypertrophied tonsils at the base of the tongue, and 1 patient (2.9%) with grade 4 tonsil and Mallampati hypertrophy were found during regular otolaryngologist endoscopy. The soft palate, lateral pharyngeal wall, base of the tongue, and epiglottis all completely collapsed at 41.2%, 70.6%, 0%, and 2.9%, respectively, during the Muller maneuver.


Conclusions: The Muller maneuver provides a basis for accurately diagnosing the location of airway narrowing causing snoring/sleep apnea and planning appropriate treatment, contributing to improving treatment quality.

Article Details

References

[1] Benjafield A.V et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med, 2019, 7 (8): p. 687-698.
[2] Camey P.R, Berry R.D, Geyer J.D. Clinical Sleep Disorders, 1st ed, Lippincott Williams & Wilkins, 2005.
[3] Gabryelska A, Białasiewicz P. Association between excessive daytime sleepiness, REM phenotype and severity of obstructive sleep apnea. Scientific Reports, 2020, 10 (1): p. 34.
[4] Kezirian E.J, Hohenhorst W, de Vries N. Drug-induced sleep endoscopy: the VOTE classification. Eur Arch Otorhinolaryngol, 2011, 268 (8): p. 1233-1236.
[5] Lavie P et al. The effects of partial and complete mechanical occlusion of the nasal passages on sleep structure and breathing in sleep. Acta Otolaryngol, 1983, 95 (1-2): p. 161-166.
[6] Shah J.A et al. Obstructive Sleep Apnea: Role of an Otorhinolaryngologist. Indian J Otolaryngol Head Neck Surg, 2016, 68 (1): p. 71-74.
[7] Chang E.T et al. The relationship of the uvula with snoring and obstructive sleep apnea: a systematic review. Sleep Breath, 2018, 22 (4): p. 955-961.
[8] Cahali M.B et al. Tonsil volume, tonsil grade and obstructive sleep apnea: is there any meaningful correlation? Clinics (Sao Paulo), 2011, 66 (8): p. 1347-52
[9] Smith M.M, Peterson E, Yaremchuk K.L. The Role of Tonsillectomy in Adults with Tonsillar Hypertrophy and Obstructive Sleep Apnea. Otolaryngol Head Neck Surg, 2017, 157 (2): p. 331-335.
[10] Amirzargar B, Sadeghi M, Saedi B. Muller’s Maneuver in Patients with Obstructive Sleep Apnea. Journal of Sleep Sciences, 2016, 1.