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Relationship between level CPAP titration, anthropometric variables, and drug-induced sleep endoscopy DISE

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Abstract

Introduction

Subjects with palatal obstruction alone vs. multilevel obstruction on DISE had better outcomes after palate surgery. We asked ourselves if the therapeutic level positive airway pressure (PAP) titration could predict the level of airway obstruction and its complexity.

Purpose

The aim of this study was to identify possible relationships between therapeutic level of positive airway pressure initial titration and levels of collapse in drug-induced sleep endoscopy (DISE). A secondary objective was to establish the relationship the other variables and DISE.

Methods

We analyzed retrospective clinical histories between March 2020 to March 2022 of 37 patients with polysomnography or cardiorespiratory polygraphy studies and PAP initial titration who were taken to drug-induced sleep endoscopy. Sleep study data, anthropometric variables, and patterns of airway collapse during DISE were analyzed with PAP initial titration levels.

Results

Most of the patients with complex collapse had concentric velum collapse (p < 0.006). A significant association was found between the apnea–hypopnea index (AHI) and oropharyngeal collapse; (p < 0.0030) and finally we demonstrated relationship between neck circumference and gender with epiglottis collapse (p < 0.046), (p < 0.037), respectively.

Conclusions

Our findings show a strong relationship between that complex collapses and concentric velum collapse; patients with greater oropharyngeal collapse have a higher mean AHI. Patients without epiglottic collapse have a higher mean neck circumference. An association between mean pressure initial titration and complex collapse could not be established.

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Funding

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Authors and Affiliations

  1. Otolaryngology Resident of the Universidad del Rosario, Escuela de Medicina y Ciencias de la Salud, Bogotá, Colombia

    Shirley Andrea Ramírez Merlano

  2. Department of Otolaryngology, Clínica Alemana de Santiago, Vitacura, Chile

    Giorgio Pio Repetto

  3. Department of Otolaryngology, Red de Salud UC Christus, Santiago, Chile

    Rodrigo Aliaga Durán

  4. Department of Otolaryngology, Hospital Naval Almirante Nef, Viña del Mar, Chile

    Jorge Astudillo Silva

  5. Department of Otolaryngology, Grupo Médico San Pedro, Monterrey, Mexico

    Rodolfo Lugo Saldaña

Authors
  1. Shirley Andrea Ramírez Merlano
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  2. Giorgio Pio Repetto
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  3. Rodrigo Aliaga Durán
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  4. Jorge Astudillo Silva
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  5. Rodolfo Lugo Saldaña
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Correspondence to Shirley Andrea Ramírez Merlano.

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This article is part of the Topical Collection on sleep apnea syndrome. Guest editors: Manuele Casale, Rinaldi Vittorio.

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Merlano, S.A.R., Repetto, G.P., Durán, R.A. et al. Relationship between level CPAP titration, anthropometric variables, and drug-induced sleep endoscopy DISE. Eur Arch Otorhinolaryngol 280, 1353–1359 (2023). https://doi.org/10.1007/s00405-022-07771-3

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