Physiologic and anatomic determinants of hyoid motion during drug-induced sleep endoscopy

• DOI: 10.1007/s11325-024-03101-5
• Publication Date: 2024-07-11T03:36:05Z
• Authors: Manan H. Parekh; Eric Thuler; Vasiliki Triantaf...; Everett Seay; Chandra Sehgal; Susan Schultz; Brendan T. Keenan; Alan R. Schwartz; Raj C. Dedhia
• Keywords: Hyoid bone; Epiglottis; Supine position

Abstract Purpose To examine factors accounting for differences in hyoid motion during obstructive breathing events amongst sleep apnea (OSA) patients. Methods This was a prospective cohort study from June 2022 to October 2022. Patients with OSA undergoing evaluation PAP alternative therapies drug-induced endoscopy positive airway pressure titration (DISE-PAP). All patients underwent DISE-PAP and concurrent hyoid-focused ultrasound. enabled measurement of physiology (flow, respiratory effort) collapsibility (pharyngeal opening pressure, PhOP). Hyoid-ultrasound bone movement breathing. Respiratory effort measured using retro-epiglottic pressure-sensitive catheter. Hyoid position standardized, awake, CT protocol. Regression analyses adjusted age, race, sex, BMI were performed associate indices data motion. Results On average, the 26 this older (63.9 ± 10.5 years), male (69%), overweight (29.6 3.99 kg/m 2 ), moderate-to-severe (26.8 10.4 events/hour). Greater associated increased (β [95% CI] = 0.034 [0.016,0.052], standardized β 0.261,p 0.0003). Higher greater displacement -0.20 [-0.38,-0.01], Standardized -0.57, p 0.036). Conclusion Our demonstrate that effort, higher position, collapsibility, but not airflow, are DISE. These findings suggest downward represents compensatory response upper obstruction. Further studies should investigate vectors better understand its role sleep-related collapse.