Pharyngolaryngoscopic results in patients with OSAS and rhonchopathy

Background and objective. The localization of an upper airway collapse in snorers and patients suffering from obstructive sleep apnea was a subject frequently discussed in the last few years. Pharyngolaryngoscopy during sleep or drug-induced sleep allows evaluation of upper airway conditions. Patients/methods. A total of 324 patients suffering from snoring or obstructive sleep apnea underwent flexible pharyngolaryngoscopy while awake and under propofol-induced sedation in the course of routine diagnostic procedures in the sleeping lab. In this study,the results of pharyngolaryngoscopy are compared to results of the Muller maneuver and polysomnographic recordings. The therapeutic consequences of this additional investigation are discussed. Results. in 95% of cases snaring was observed during drug-induced sleep. A significant discrepancy was seen between results of the endoscopy while being awake (Muller maneuver) and during drug-induced sleep. The degree of collapse differed significantly in the area of the base of the tongue. Severe collapse was seen much more often with pharyngoscopy during drug-induced sleep compared to the results during the Muller maneuver. Conclusions. The collapsibility in the area of the base of the tongue correlated with higher results in the RDI (respiratory disturbance index) registered with standard polysomnography. Snoring and upper airway collapse were easily surveyed, and the pharyngolaryngoscopy during propofol-induced sleep proved to be a simple,safe, readily controllable and effective supplementary diagnostic device for the diagnosis and treatment of obstructive sleep apnea and snoring.