Defining Epiglottic Collapses Patterns in Obstructive Sleep Apnea Patients: Francia-Lugo Classification

Author:

Francia Carlos1,Lugo Rodolfo2ORCID,Moffa Antonio34,Casale Manuele34,Giorgi Lucrezia35ORCID,Iafrati Francesco34ORCID,Di Giovanni Simone34,Baptista Peter67

Affiliation:

1. Clínica Delgado, Lima 15074, Peru

2. ISSSTE Constitución, Monterrey 64530, Mexico

3. Integrated Therapies in Otolaryngology, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy

4. School of Medicine, Campus Bio-Medico University, 00128 Rome, Italy

5. Unit of Measurements and Biomedical Instrumentation, Department of Engineering, Campus Bio-Medico University of Rome, 00128 Rome, Italy

6. Department of Otorhinolaryngology, Clínica Universidad de Navarra, 31008 Pamplona, Spain

7. ENT Department, Al Zahra Private Hospital Dubai, Dubai 23614, United Arab Emirates

Abstract

Obstructive Sleep Apnea (OSA) is characterized by repetitive collapse of the upper airway during sleep. Drug-Induced Sleep endoscopy (DISE) is used to identify the collapse site. Among the possible sites of collapse, the epiglottis occurs more frequently than previously described. In this study, we reviewed DISE findings and classified different epiglottic collapse patterns. We found 104 patients (16.4%) with epiglottis collapse (primary 12.5% and secondary 3.9%). We described the following patterns of epiglottis collapse: Anterior–Posterior (AP) collapse with rigid component “trapdoor type” (48%); AP collapse with lax component “floppy type” (13.5%); Lateral– Lateral (LL) collapse with omega shape component “book type” (14.5%); and secondary due to lateral pharyngeal wall or tongue base collapse (24%). The identification of the epiglottic collapse pattern is crucial in decision-making when attempting to ameliorate OSA. These findings in OSA phenotyping could influence the type of treatment chosen.

Publisher

MDPI AG

Subject

Health Information Management,Health Informatics,Health Policy,Leadership and Management

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