EK Sign: A Wrinkling of Uvula and the Base of Uvula in Obstructive Sleep Apnea-Hypopnea Syndrome

Introduction. Diagnosis of obstructive sleep apnea-hypopnea syndrome (OSAHS) is suspected in the presence of symptoms and/or pharyngeal alterations and skeletal abnormalities of maxilla and mandible. Our aim is to find a new clinical sign that leads to suspicion of OSAHS in snorers. Methods. We reviewed the clinical data of 69 snoring patients with or without OSAHS. We defined EK sign as the presence of horizontal wrinkling of uvula and the base of uvula and tried to correlate its presence with OSAHS. Results. EK sign was present in 25 of 69 patients. The positive predictive value of EK sign is 100%. The presence of EK sign significantly correlated with OSAHS (44% if AHI ≥ 5 and 0% if AHI < 5; p = 0.01) and severity of OSAHS (7% if AHI < 15 and 58% with AHI ≥ 15; p < 0.001). Conclusions. The EK sign is a strong predictor of OSAHS with a specificity of 100%. We recommend performing sleep tests in presence of EK sign in snorers even in the absence of other abnormalities or symptoms.