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...
| Publicado en: | Laryngoscope Vol. 109; no. 6; pp. 954 - 964 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | diagnostic images pictorial research tables/charts tracings Journal Article |
| Publicado: |
Wiley-Blackwell
1999
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107203796&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107203796 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0023852X 1GR jtl: Laryngoscope issn: 0023852X maglogo: Y pubinfo: dt: 1999 vid: 109 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 107203796 107203796 NLM10369290 1999055745 NLM10369290 107203796 ppf: 954 ppct: 10 formats: tig: atl: Quantitative evaluation of the upper airway during nasopharyngoscopy with the Müller maneuver. aug: au: 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 sug: 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 refInfo: holdings: @attributes: islocal: N |
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