Quantitative evaluation of the upper airway during nasopharyngoscopy with the Müller maneuver.

Objective: To quantitatively examine changes in the upper airway caliber of normal subjects at graded negative inspiratory pressures generated during nasopharyngoscopy with a Müller maneuver.Study Design: Eighteen normal subjects prospectively underwent nasopharyngoscopy with Müller maneuvers. Subje...

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Publicado en:Laryngoscope Vol. 109; no. 6; pp. 954 - 964
Autores principales: Ritter CT, Trudo FJ, Goldberg AN, Welch KC, Maislin G, Schwab RJ, Ritter, C T, Trudo, F J, Goldberg, A N, Welch, K C, Maislin, G, Schwab, R J
Formato: diagnostic images pictorial research tables/charts tracings Journal Article
Publicado: Wiley-Blackwell 1999
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
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        atl: Quantitative evaluation of the upper airway during nasopharyngoscopy with the Müller maneuver.
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          Ritter CT
          Trudo FJ
          Goldberg AN
          Welch KC
          Maislin G
          Schwab RJ
          Ritter, C T
          Trudo, F J
          Goldberg, A N
          Welch, K C
          Maislin, G
          Schwab, R J
        affil: Center for Sleep and Respiratory Neurobiology, Department of Medicine, University of Pennsylvania Medical Center, Philadelphia 19104-4283, USA
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        subj:
          Nose Anatomy and Histology
          Pharynx Anatomy and Histology
          Nose Physiology
          Pharynx Physiology
          Vital Capacity
          Endoscopy
          Image Processing, Computer Assisted
          Male
          Adult
          Female
          Polysomnography
          Reference Values
          Respiratory Function Tests
          Research Subject Recruitment
          Independent Variable
          Dependent Variable
          Pearson's Correlation Coefficient
          Analysis of Variance
          Coefficient alpha
          Statistical Significance
          Repeated Measures
          Hypothesis
          Algorithms
          Funding Source
          Human
          Adult: 19-44 years
          Male
          Female
      ab: Objective: To quantitatively examine changes in the upper airway caliber of normal subjects at graded negative inspiratory pressures generated during nasopharyngoscopy with a Müller maneuver.Study Design: Eighteen normal subjects prospectively underwent nasopharyngoscopy with Müller maneuvers. Subjects performed graded and maximal effort Müller maneuvers while sitting upright, and maximal-effort Müller maneuvers in the supine position. Two regions of the upper airway--the retropalatal and retroglossal--were examined.Methods: Images from the endoscopic examination were objectively analyzed by adjusting manually traced airway contours using full-width, half-maximum edge detection algorithm software. The adjusted tracings' area and dimensions through the airway centroid were measured.Results: Müller maneuvers performed at -40 cm H2O resulted in a 64%+/-17% (P = .0001) reduction in upper airway area that consisted of a 51%+/-20% (P = .0001) reduction in the lateral dimension and a 21%+/-24% (P = .0026) reduction in antero-posterior dimension. Müller maneuvers in the retroglossal region did not significantly reduce airway area (P = .575), but demonstrated an altered airway conformation that consisted of lateral narrowing and an increase in antero-posterior dimension. Changes in body position did not result in significant differences in either airway caliber or airway dimension.Conclusions: Airway caliber during forced inspiration is mediated primarily through changes in the lateral pharyngeal walls. This study has also shown that antero-posterior and lateral airway structures are largely independent in their response to Müller maneuvers. Similarly, the retropalatal and retroglossal regions of the upper airway respond differently to forced negative intraluminal pressure.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
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