THE DIAGNOSTIC VALUE OF TRANSNASAL FIBROLARYNGOSCOPY WITH A MULLER TEST IN THE CHOICE OF TREATMENT TACTICS IN A PATIENT WITH MODERATE RONCHOPATHY AND OSA. A CLINICAL CASE.
- Authors: Ryabova M.A.1, Kralina D.O.2,3
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Affiliations:
- 1Pavlov First Saint Petersburg State Medical University Department of Otorhinolaryngology
- Pavlov First Saint Petersburg State Medical University Department of Otorhinolaryngology
- 2St. Petersburg City Hospital of St. George The Great Martyr
- Section: Клиническая оториноларингология
- URL: https://journals.eco-vector.com/2310-3825/article/view/627122
- DOI: https://doi.org/10.33848/fopr627122
- ID: 627122
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Abstract
The problem of choosing therapeutic tactics in patients with obstructive sleep apnea syndrome (OSA) does not lose its relevance, despite the wide variety of both conservative and surgical methods of treatment of this pathology. Diagnosis of the level and degree of obstruction of the upper respiratory tract can be carried out by endoscopic examination, both in the waking state and during drug-induced sleep. Considering that the majority of patients with OSA are elderly people with a burdened somatic history, belonging to the group of high anesthesiological risk, it is important to have the most complete examination to choose the optimal treatment tactics. The article presents a clinical case that illustrates in detail the choice and justification of therapeutic tactics in a patient with moderate snoring and OSA.
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About the authors
Marina A. Ryabova
1Pavlov First Saint Petersburg State Medical University Department of Otorhinolaryngology
Email: marinaryabova@mail.ru
ORCID iD: 0000-0002-6714-9454
SPIN-code: 3951-7190
DMSc, Professor of the ENT department, «Pavlov First Saint Petersburg State Medical University»,
Russian Federation, 197022 Russia, St. Petersburg, L. Tolstoy stDarya O. Kralina
Pavlov First Saint Petersburg State Medical University Department of Otorhinolaryngology;2St. Petersburg City Hospital of St. George The Great Martyr
Author for correspondence.
Email: rogova_dasha@mail.ru
ORCID iD: 0009-0003-0160-9192
Postgraduate student of the Department of Otorhinolaryngology; ENT-specialist
Russian Federation, 197022 Russia, St. Petersburg, L. Tolstoy st; 194354, Russian Federation, Saint Petersburg, Severnyi stReferences
- Uryas'ev O.M., ZHukova L.A., Glotov S.I., Alekseeva E.A., Ponomareva I.B., Almazova E.V. Dvustoronnij paralich diafragmy: klinicheskoe nablyudenie.[Bilateral paralysis of the diaphragm: a clinical observation.] // Pul'monologiya.2022.№32 (6). pp. 906–914. (In Russ.)
- doi: 10.18093/0869-0189-2022-32-6-906-914
- Kapustina N. A., Kolosov A. A. Vzaimosvyaz' narushenij funkcional'nogo sostoyaniya dyhatel'nyh myshc i giperreaktivnosti dyhatel'nyh putej u bol'nyh hronicheskim neobstruktivnym bronhitom i hronicheskoj obstruktivnoj bolezn'yu legkih.[The relationship between disorders of the functional state of the respiratory muscles and hyperreactivity of the respiratory tract in patients with chronic non-obstructive bronchitis and chronic obstructive pulmonary disease]// Byulleten' fiziologii i patologii dyhaniya.2006. №22. (In Russ.). Available at: https://cyberleninka.ru/article/n/vzaimosvyaz-narusheniy-funktsionalnogo-sostoyaniya-dyhatelnyh-myshts-i-giperreaktivnosti-dyhatelnyh-putey-u-bolnyh-hronicheskim Accessed February
- , 2024.
- Gottlieb DJ, Punjabi NM. Diagnosis and Management of Obstructive Sleep Apnea: A Review. JAMA. 2020;323(14):1389–1400.
- doi: 10.1001/jama.2020.3514
- Ryabova M.A., Faizova A.R., Volchkov E.A. Otsrochennye rezul'taty posle lazernoj nerezekcionnoj uvulopalatoplastiki:[Long-term results after laser-assisted non-resectionary uvulopalatoplasty.] // Folia Otorhinolaryngologiae et Pathologiae Respiratoriae. 2023; 29 (1): pp. 28-34. (In Russ.)
- doi: 10.33848/foliorl23103825-2023-29-1-28-34
- Karpishchenko S., Aleksandrov A., Sopko O., Arustamyan I., Mushnikova YU. Konservativnaya terapiya hrapa i sindroma obstruktivnogo apnoe vo sne // Vrach. 2016. №2. (In Russ.)
- https://cyberleninka.ru/article/n/konservativnaya-terapiya-hrapa-i-sindroma-obstruktivnogoapnoe-vo-sne Accessed February 07, 2024.
- Kolyadich, ZH. V. Analiz diagnosticheskoj znachimosti endoskopicheskogo issledovaniya verhnih dyhatel'nyh putej u pacientov s sindromom obstruktivnogo apnoe vo sne.[ Analysis of the diagnostic significance of endoscopic examination of the upper respiratory tract in patients with obstructive sleep apnea syndrome] // Rossijskaya otorinolaringologiya. 2014. №6 (73): pp. 57-61. (In Russ.). – EDN TFFXLV
- Zerpa Zerpa V, Carrasco Llatas M, Agostini Porras G, Dalmau Galofre J. Drug-induced sedation endoscopy versus clinical exploration for the diagnosis of severe upper airway obstruction in OSAHS patients. Sleep Breath. 2015 Dec;19(4):1367-72. doi: 10.1007/s11325-015-1266-z. Epub 2015 Oct 8. PMID: 26449550.
- Soares D, Folbe AJ, Yoo G, Badr MS, Rowley JA, Lin HS. Drug-induced sleep endoscopy vs awake Müller's maneuver in the diagnosis of severe upper airway obstruction. Otolaryngol Head Neck Surg. 2013 Jan;148(1):151-6. doi: 10.1177/0194599812460505. Epub 2012 Sep 11. PMID: 22968669; PMCID: PMC3870200.
- Van den Bossche K, Van de Perck E, Wellman A, Kazemeini E, Willemen M, Verbraecken J, Vanderveken OM, Vena D, Op de Beeck S. Comparison of Drug-Induced Sleep Endoscopy and Natural Sleep Endoscopy in the Assessment of Upper Airway Pathophysiology During Sleep: Protocol and Study Design. Front Neurol. 2021 Dec 7;12:768973. doi: 10.3389/fneur.2021.768973. PMID: 34950101; PMCID: PMC8690862.
- Kezirian E.J., Hohenhorst W., De Vries N. Drug-induced sleep endoscopy: the VOTE classification. Eur Arch Otorhino-laryngol. 2011;268:1233-1236.
- Kolyadich, ZH. V., Kalinkin A. L. Sindrom obstruktivnogo apnoe sna: vzglyad otorinolaringologa i somnologa.[Obstructive sleep apnea syndrome: the view of an otorhinolaryngologist and a somnologist] // Terapiya.2016, №1(5), pp. 57-61. (In Russ.) EDN VZLIJP.
- Wang WM, Hsu YB, Lan MY, Yang MC, Huang TT, Liu CJ, Lan MC. The Relationship Between Modified Mallampati Score, Müller's Maneuver and Drug-Induced Sleep Endoscopy Regarding Retrolingual Obstruction. Ann Otol Rhinol Laryngol. 2018 Jul;127(7):463-469. doi: 10.1177/0003489418778302. Epub 2018 Jun 1. PMID: 29852751.
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