Abstract
Objective of the study was to evaluate the reliability of Muller’s maneuver (MM) with the severity of obstructive sleep apnea (OSA) at the retropalatal level. Case series of 58 adult patients diagnosed to have OSA. Sleep apnoea clinic in a tertiary referral center in south India. Fifty-eight adult OSA patients underwent outpatient based MM under local anaesthesia. Collapse of hypopharynx and the retroglossal regions were assessed during a maximal inspiratory effort against the closed mouth and sealed nose (reverse valsalva). Correlation co efficient was used to compare MM grade with apnea–hypopnea index (AHI) scores. Severity of OSA based on AHI scores were compared with the results of Muller’s maneuver at the retropalatal level. The correlation coefficient was 0.213, hence no correlation was found, p value was 0.019, which was not statistically significant. MM is an useful tool for evaluation of upper airway collapse. The advantages include simplicity, cost-effectiveness, relatively easy to perform, thorough evaluation of upper airway. The pitfalls of the procedure includes the subjectiveness of the procedure and the fact that it is performed on awake patients and therefore remains an indirect estimation of obstruction that occurs during sleep. In our study, we did not find correlation between the severity of OSA based on the AHI scores and the collapse at the retropalate level assessed by the Muller’s maneuver.
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References
Goldberg AN, Schwab RJ (1998) Identifying the patient with sleep apnea. Otolaryngol Clin North Am 51:919–930
Terris DJ, Hanasono MM, Liu YC (2000) Reliability of the Muller maneuver and its association with sleep-disordered breathing. Laryngoscope 110:1819–1823
Thog JF, Pang KP (2008) Clinical parameters in obstructive sleep apnea: are there any correlations? J Otolaryngol Head Neck Surg 37(6):894–900
Trudo FJ, Gefter WB, Welch KC, Maislin G, Scwab RJ (1998) State related changes in upper airway calober and surrounding soft tissue structures in normals. Am J Respir Crit Care Med 158:1259–1270
Borowiecki BD, Sassin JF (1983) Surgical treatment of sleep apnea. Arch Otolaryngol 109:506–512
Sher AE, Thorpy MJ, Shprintzen RJ et al (1985) Predictive value of Muller maneuver in selection of patients for uvulopalatopharyngoplasty. Laryngoscope 95:1483–1487
Tuncel U, Inancli HM, Kurkcuoglu SS, Enoz M (2010) Can the MM detect multilevel obstruction of upper airway in patients with OSA syndromes? Kulak Burun Bogaz Ihlis Derg 20(4):84–88
Woodson BT, Wooten MR (1994) Comparison of upper-airway evaluations during wakefulness and sleep. Laryngoscope 104:821–828
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Suresh, R.K., Nair, A.B., Sreenivas, V. et al. Correlation Between Retropalatal Collapse as Observed During Muller’s Maneuver to Severity of OSA. Indian J Otolaryngol Head Neck Surg 67, 135–137 (2015). https://doi.org/10.1007/s12070-015-0847-2
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DOI: https://doi.org/10.1007/s12070-015-0847-2