ORIGINAL ARTICLE   

Otorinolaringologia 2018 June;68(2):47-50

DOI: 10.23736/S0392-6621.18.02150-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Nasal airflow morphology assessed by home respiratory polygraphy as a predictor of severity and sites of obstruction in obstructive sleep apnea syndrome

Annalisa ENRICO ¹, Giuseppe RIVA ¹ ✉, Alessandro CICOLIN ², Elena PIUMETTO ³, Carmine F. GERVASIO ¹

¹ Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy; ² Sleep Disorder Center, Department of Neurosciences, University of Turin, Turin, Italy; ³ Division of Otorhinolaryngology, Sant’Annunziata Hospital, Savigliano, Cuneo, Italy

BACKGROUND: The diagnosis and the severity of obstructive sleep apnea syndrome (OSAS) is based on the Apnea-Hypopnea Index. However, nasal airflow morphology may add important data. The primary aim of this retrospective observational study was to evaluate nasal airflow morphology of 21 patients with OSAS who underwent drug-induced sleep endoscopy (DISE). Our secondary aim was to assess the possibility to use these features as predictors of severity and sites of obstruction.
METHODS: Home respiratory poligraphies of 21 patients were evaluated with a specific focus on nasal airflow. It was assessed according to the predominant airflow morphology. We evaluated possible correlations between airflow morphology, and sites and severity of obstruction at DISE. In particular, our attention focused on oropharyngeal/retropalatal and hypopharyngeal/retrolingual collapse.
RESULTS: The majority of patients had an inspiratory flow limitation with or without inspiratory snoring (71.4% of cases). Expiratory mouth breathing was observed in 14.3% of patients. Subjects with expiratory snoring had a worse pharyngeal collapse at DISE (100% of cases with maximum grade of collapse both in oropharynx and hypopharynx). Our preliminary study failed to find a statistical significance because of the small sample.
CONCLUSIONS: Nasal airflow morphology assessed by home respiratory polygraphy could be useful as predictor of severity and site of obstruction at drug-induced sleep endoscopy. Patients with expiratory snoring should have highest priority for the execution of DISE and consequent treatment.

KEY WORDS: Obstructive sleep apnea - Endoscopy - Polysomnography - Nasal obstruction