Association Between Breathing Route, Oxygen Desaturation, and Upper Airway Morphology

Objectives/Hypothesis This study aimed to assess the role of capnography in objectively evaluating breathing routes during drug‐induced sleep endoscopy (DISE) and further elucidate the relationship between breathing route, obstructive sleep apnea (OSA) severity, and DISE findings. Study Design Prosp...

Full description

Saved in:
Bibliographic Details
Published in:The Laryngoscope 2021-02, Vol.131 (2), p.E659-E664
Main Authors: Hsu, Yen‐Bin, Lan, Ming‐Ying, Huang, Yun‐Chen, Kao, Ming‐Chang, Lan, Ming‐Chin
Format: Article
Language:English
Subjects:
Anesthesia
breathing route
Capnography - methods
drug‐induced sleep endoscopy
Female
Humans
Laryngoscopy
Male
Middle Aged
Oxygen - blood
oxygen desaturation
Polysomnography
propofol
Prospective Studies
Respiration
Respiratory System - pathology
Sleep apnea
Sleep Apnea, Obstructive - metabolism
Sleep Apnea, Obstructive - pathology
Sleep Apnea, Obstructive - physiopathology
upper airway
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objectives/Hypothesis This study aimed to assess the role of capnography in objectively evaluating breathing routes during drug‐induced sleep endoscopy (DISE) and further elucidate the relationship between breathing route, obstructive sleep apnea (OSA) severity, and DISE findings. Study Design Prospective observational study. Methods Nighty‐five patients with established OSA were recruited for this study from May 2017 to May 2019. DISE was performed in the operating room. Sedation was maintained with propofol using a target‐controlled infusion system and the depth of sedation was monitored based on the bispectral index. The breathing routes, which included oral breathing, oronasal breathing, and nasal breathing, were detected using capnography. DISE findings were recorded using the VOTE (velum, oropharynx, base of tongue, and epiglottis) classification. Results Patients with mouth breathing were associated with increased OSA severity, worse oximetric variables, and higher body mass index in comparison with those with other breathing routes. Mouth breathing was associated with a higher degree and higher prevalence of lateral pharyngeal wall collapse and tongue base collapse during DISE. Conclusions Mouth breathing was significantly associated with worse oxygen desaturation and increased degree of upper airway collapse. Therefore, patients with mouth breathing during propofol‐based intravenous anesthesia should be carefully monitored. Level of Evidence 4 Laryngoscope, 131:E659–E664, 2021
ISSN:0023-852X
1531-4995
DOI:10.1002/lary.28774