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LwPTL: a novel classification for upper airway collapse in sleep endoscopies()

INTRODUCTION: There is no consensus on a single classification system for the obstructive findings in drug-induced sleep endoscopy. Previous classification systems have neglected to address the upper retropalatal obstruction, the segmental division of the lateral pharyngeal wall and the primary or s...

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Autores principales: Elsobki, Ahmed, Cahali, Michel Burihan, Kahwagi, Mohamed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9442889/
https://www.ncbi.nlm.nih.gov/pubmed/30902587
http://dx.doi.org/10.1016/j.bjorl.2019.01.010
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author Elsobki, Ahmed
Cahali, Michel Burihan
Kahwagi, Mohamed
author_facet Elsobki, Ahmed
Cahali, Michel Burihan
Kahwagi, Mohamed
author_sort Elsobki, Ahmed
collection PubMed
description INTRODUCTION: There is no consensus on a single classification system for the obstructive findings in drug-induced sleep endoscopy. Previous classification systems have neglected to address the upper retropalatal obstruction, the segmental division of the lateral pharyngeal wall and the primary or secondary nature of laryngeal collapse. OBJECTIVE: To propose, illustrate and evaluate a more comprehensive and yet simple classification for drug-induced sleep endoscopy findings. METHODS: Cross sectional study in a tertiary sleep surgery unit. A total of 30 patients with obstructive sleep apnea underwent drug-induced sleep endoscopy according to a new classification system called LwPTL, and its findings were analyzed according to obstructive sleep apnea severity and body mass index. LwPTL incorporates the description of upper retropalatal collapse, distinguishes the lateral pharyngeal wall collapse into three levels and clarify when laryngeal collapses are primary or secondary. RESULTS: 93.3% of the patients presented lateral pharyngeal wall collapse, usually at the level of the velum (73.3%). 80% presented multilevel collapse. Regarding the upper retropalatal region, LwPTL identified 10% of the cases presenting lateral salpingopharyngeal obstruction and 6.6% with high palatal collapse. 3.3% presented epiglottic collapse. Patients presenting lower levels of collapse, either from the lateral wall and/or tongue and/or larynx, represented 30% of the cases and had significantly more severe obstructive sleep apnea, without significant differences in body mass indexes. CONCLUSION: LwPTL seems a simple and straightforward staging system for classifying drug-induced sleep endoscopy, distinguishing the important upper retopalatal obstruction and the primary and secondary laryngeal collapses, providing more information for appropriate treatment selection.
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spelling pubmed-94428892022-09-09 LwPTL: a novel classification for upper airway collapse in sleep endoscopies() Elsobki, Ahmed Cahali, Michel Burihan Kahwagi, Mohamed Braz J Otorhinolaryngol Review Article INTRODUCTION: There is no consensus on a single classification system for the obstructive findings in drug-induced sleep endoscopy. Previous classification systems have neglected to address the upper retropalatal obstruction, the segmental division of the lateral pharyngeal wall and the primary or secondary nature of laryngeal collapse. OBJECTIVE: To propose, illustrate and evaluate a more comprehensive and yet simple classification for drug-induced sleep endoscopy findings. METHODS: Cross sectional study in a tertiary sleep surgery unit. A total of 30 patients with obstructive sleep apnea underwent drug-induced sleep endoscopy according to a new classification system called LwPTL, and its findings were analyzed according to obstructive sleep apnea severity and body mass index. LwPTL incorporates the description of upper retropalatal collapse, distinguishes the lateral pharyngeal wall collapse into three levels and clarify when laryngeal collapses are primary or secondary. RESULTS: 93.3% of the patients presented lateral pharyngeal wall collapse, usually at the level of the velum (73.3%). 80% presented multilevel collapse. Regarding the upper retropalatal region, LwPTL identified 10% of the cases presenting lateral salpingopharyngeal obstruction and 6.6% with high palatal collapse. 3.3% presented epiglottic collapse. Patients presenting lower levels of collapse, either from the lateral wall and/or tongue and/or larynx, represented 30% of the cases and had significantly more severe obstructive sleep apnea, without significant differences in body mass indexes. CONCLUSION: LwPTL seems a simple and straightforward staging system for classifying drug-induced sleep endoscopy, distinguishing the important upper retopalatal obstruction and the primary and secondary laryngeal collapses, providing more information for appropriate treatment selection. Elsevier 2019-03-08 /pmc/articles/PMC9442889/ /pubmed/30902587 http://dx.doi.org/10.1016/j.bjorl.2019.01.010 Text en © 2019 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review Article
Elsobki, Ahmed
Cahali, Michel Burihan
Kahwagi, Mohamed
LwPTL: a novel classification for upper airway collapse in sleep endoscopies()
title LwPTL: a novel classification for upper airway collapse in sleep endoscopies()
title_full LwPTL: a novel classification for upper airway collapse in sleep endoscopies()
title_fullStr LwPTL: a novel classification for upper airway collapse in sleep endoscopies()
title_full_unstemmed LwPTL: a novel classification for upper airway collapse in sleep endoscopies()
title_short LwPTL: a novel classification for upper airway collapse in sleep endoscopies()
title_sort lwptl: a novel classification for upper airway collapse in sleep endoscopies()
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9442889/
https://www.ncbi.nlm.nih.gov/pubmed/30902587
http://dx.doi.org/10.1016/j.bjorl.2019.01.010
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