High Tongue Position is a Risk Factor for Upper Airway Concentric Collapse in Obstructive Sleep Apnea: Observation Through Sleep Endoscopy

Chen Zhao,1,2 Alonço Viana,2– 4 Yifei Ma,5 Robson Capasso2 1Department of Otorhinolaryngology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China; 2Division of Sleep Surgery, Department of Otolaryngology- Head &...

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Autores principales:	Zhao C, Viana A, Ma Y, Capasso R
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	drug-induced sedation endoscopy sleep endoscopy obstructive sleep apnea tongue position upper airway collapse complete concentric collapse Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/032e38bac58e4630aff2fff31b1fb11d
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spelling	oai:doaj.org-article:032e38bac58e4630aff2fff31b1fb11d2021-12-02T13:08:14ZHigh Tongue Position is a Risk Factor for Upper Airway Concentric Collapse in Obstructive Sleep Apnea: Observation Through Sleep Endoscopy1179-1608https://doaj.org/article/032e38bac58e4630aff2fff31b1fb11d2020-10-01T00:00:00Zhttps://test.dovepress.com/high-tongue-position-is-a-risk-factor-for-upper-airway-concentric-coll-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Chen Zhao,1,2 Alonço Viana,2– 4 Yifei Ma,5 Robson Capasso2 1Department of Otorhinolaryngology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China; 2Division of Sleep Surgery, Department of Otolaryngology- Head & Neck Surgery, Stanford University Medical Center, Stanford, CA, USA; 3Graduate Program of Neurology, Rio de Janeiro State Federal University (UNIRIO), Rio de Janeiro, Brazil; 4Department of Otorhinolaryngology, Marcílio Dias Naval Hospital, Rio de Janeiro, Brazil; 5Department of Otolaryngology- Head & Neck Surgery, Stanford University Medical Center, Stanford, CA, USACorrespondence: Chen ZhaoDepartment of Otorhinolaryngology, The First Affiliated Hospital of China Medical University, No. 155, North Nanjing Street, Heping District, Shenyang, Liaoning 110001, People’s Republic of ChinaTel +86 13998856576Fax +86 02483282997Email zhaochen@cmu.edu.cnPurpose: Identification of upper airway (UA) obstruction based on pharyngeal factors is important for obstructive sleep apnea (OSA) evaluation. This study is to assess the association between UA collapse characteristics and Friedman tongue position (FTP) in patients with OSA through drug-induced sleep endoscopy (DISE).Patients and Methods: Retrospective study in individuals with OSA who were intolerant to continuous positive airway pressure (CPAP) treatment, submitted to DISE between June 1, 2013, and July 31, 2017. All subjects were classified as having an FTP grade of I to IV, and the velum, oropharynx, tongue base, epiglottis (VOTE) classification was used to analyze the DISE findings. UA collapse characteristics by DISE and FTP grading were compared between groups. The associations between specific DISE findings and FTP were analyzed.Results: In total, 205 patients were assessed. A positive and significant correlation was identified between the presence of retropalatal complete concentric collapse (CCC) and FTP grade, according to the following distributions: I, 17.4%; II, 22.9%; III, 33.7%; and IV, 48.7% (P = 0.014). A logistic regression model revealed that CCC was associated with FTP grade IV. After adjusting for age, sex, body mass index (BMI), and tonsil size (TS), the grade IV individuals had a 4.4-fold higher risk of having CCC than grade I individuals (P = 0.026). Multiple collapse sites and palatopharyngeal or combined (palatopharyngeal and hypopharyngeal) collapse were more prevalent in grade IV individuals.Conclusion: OSA patients intolerant to CPAP have a strong positive correlation between the FTP grade and presence of retropalatal CCC. FTP grade IV is an independent risk factor for velum-CCC, controlling for sex, age, BMI, and TS grade.Keywords: drug-induced sedation endoscopy, sleep endoscopy, obstructive sleep apnea, tongue position, upper airway collapse, complete concentric collapseZhao CViana AMa YCapasso RDove Medical Pressarticledrug-induced sedation endoscopysleep endoscopyobstructive sleep apneatongue positionupper airway collapsecomplete concentric collapsePsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 12, Pp 767-774 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	drug-induced sedation endoscopy sleep endoscopy obstructive sleep apnea tongue position upper airway collapse complete concentric collapse Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	drug-induced sedation endoscopy sleep endoscopy obstructive sleep apnea tongue position upper airway collapse complete concentric collapse Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Zhao C Viana A Ma Y Capasso R High Tongue Position is a Risk Factor for Upper Airway Concentric Collapse in Obstructive Sleep Apnea: Observation Through Sleep Endoscopy
description	Chen Zhao,1,2 Alonço Viana,2– 4 Yifei Ma,5 Robson Capasso2 1Department of Otorhinolaryngology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China; 2Division of Sleep Surgery, Department of Otolaryngology- Head & Neck Surgery, Stanford University Medical Center, Stanford, CA, USA; 3Graduate Program of Neurology, Rio de Janeiro State Federal University (UNIRIO), Rio de Janeiro, Brazil; 4Department of Otorhinolaryngology, Marcílio Dias Naval Hospital, Rio de Janeiro, Brazil; 5Department of Otolaryngology- Head & Neck Surgery, Stanford University Medical Center, Stanford, CA, USACorrespondence: Chen ZhaoDepartment of Otorhinolaryngology, The First Affiliated Hospital of China Medical University, No. 155, North Nanjing Street, Heping District, Shenyang, Liaoning 110001, People’s Republic of ChinaTel +86 13998856576Fax +86 02483282997Email zhaochen@cmu.edu.cnPurpose: Identification of upper airway (UA) obstruction based on pharyngeal factors is important for obstructive sleep apnea (OSA) evaluation. This study is to assess the association between UA collapse characteristics and Friedman tongue position (FTP) in patients with OSA through drug-induced sleep endoscopy (DISE).Patients and Methods: Retrospective study in individuals with OSA who were intolerant to continuous positive airway pressure (CPAP) treatment, submitted to DISE between June 1, 2013, and July 31, 2017. All subjects were classified as having an FTP grade of I to IV, and the velum, oropharynx, tongue base, epiglottis (VOTE) classification was used to analyze the DISE findings. UA collapse characteristics by DISE and FTP grading were compared between groups. The associations between specific DISE findings and FTP were analyzed.Results: In total, 205 patients were assessed. A positive and significant correlation was identified between the presence of retropalatal complete concentric collapse (CCC) and FTP grade, according to the following distributions: I, 17.4%; II, 22.9%; III, 33.7%; and IV, 48.7% (P = 0.014). A logistic regression model revealed that CCC was associated with FTP grade IV. After adjusting for age, sex, body mass index (BMI), and tonsil size (TS), the grade IV individuals had a 4.4-fold higher risk of having CCC than grade I individuals (P = 0.026). Multiple collapse sites and palatopharyngeal or combined (palatopharyngeal and hypopharyngeal) collapse were more prevalent in grade IV individuals.Conclusion: OSA patients intolerant to CPAP have a strong positive correlation between the FTP grade and presence of retropalatal CCC. FTP grade IV is an independent risk factor for velum-CCC, controlling for sex, age, BMI, and TS grade.Keywords: drug-induced sedation endoscopy, sleep endoscopy, obstructive sleep apnea, tongue position, upper airway collapse, complete concentric collapse
format	article
author	Zhao C Viana A Ma Y Capasso R
author_facet	Zhao C Viana A Ma Y Capasso R
author_sort	Zhao C
title	High Tongue Position is a Risk Factor for Upper Airway Concentric Collapse in Obstructive Sleep Apnea: Observation Through Sleep Endoscopy
title_short	High Tongue Position is a Risk Factor for Upper Airway Concentric Collapse in Obstructive Sleep Apnea: Observation Through Sleep Endoscopy
title_full	High Tongue Position is a Risk Factor for Upper Airway Concentric Collapse in Obstructive Sleep Apnea: Observation Through Sleep Endoscopy
title_fullStr	High Tongue Position is a Risk Factor for Upper Airway Concentric Collapse in Obstructive Sleep Apnea: Observation Through Sleep Endoscopy
title_full_unstemmed	High Tongue Position is a Risk Factor for Upper Airway Concentric Collapse in Obstructive Sleep Apnea: Observation Through Sleep Endoscopy
title_sort	high tongue position is a risk factor for upper airway concentric collapse in obstructive sleep apnea: observation through sleep endoscopy
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/032e38bac58e4630aff2fff31b1fb11d
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High Tongue Position is a Risk Factor for Upper Airway Concentric Collapse in Obstructive Sleep Apnea: Observation Through Sleep Endoscopy

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