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Sleep and Breathing

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24.04.2019 | Sleep Breathing Physiology and Disorders • Original Article

Floppy epiglottis during drug-induced sleep endoscopy: an almost complete resolution by adopting the lateral posture

verfasst von: P. E. Vonk, M. J. L. Ravesloot, K. M. Kasius, J. P. van Maanen, N. de Vries

Erschienen in: Sleep and Breathing | Ausgabe 1/2020

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Abstract

Purpose

To analyze the presence of a floppy epiglottis (FE) during drug-induced sleep endoscopy in non-apneic snoring patients, non-positional obstructive sleep apnea (OSA) patients (NPP), and position-dependent OSA patients (PP) and to evaluate the impact of maneuvers and body position during drug-induced sleep endoscopy, including jaw thrust and supine and lateral head (and trunk) position.

Methods

Retrospective cohort study.

Results

In total, 324 patients were included. In 60 patients (18.5%), a FE was found in supine position: seven non-apneic snoring patients and 53 OSA patients. When performing lateral head rotation only, a FE was present in four patients (NPP, N = 0; PP, N = 4). When patients were tilted to both lateral head and trunk position, a FE was found in only one subject. After applying jaw thrust, a FE was still present in 10 patients. The prevalence of a FE did not differ between NPP and PP. When comparing baseline characteristics between patients with and without a FE in supine position, no significant differences were found.

Conclusion

A FE appears almost exclusively in supine position. In patients with a FE, positional therapy can be a promising alternative as a standalone treatment, but also as part of combination therapy with for example mandibular advancement devices or less invasive forms of upper airway surgery.

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Titel: Floppy epiglottis during drug-induced sleep endoscopy: an almost complete resolution by adopting the lateral posture
verfasst von: P. E. Vonk
M. J. L. Ravesloot
K. M. Kasius
J. P. van Maanen
N. de Vries
Publikationsdatum: 24.04.2019
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 1/2020
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-019-01847-x

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