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. 2023 Oct 31;11(21):2874.
doi: 10.3390/healthcare11212874.

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

Carlos Francia  1 , Rodolfo Lugo  2 , Antonio Moffa  3   4 , Manuele Casale  3   4 , Lucrezia Giorgi  3   5 , Francesco Iafrati  3   4 , Simone Di Giovanni  3   4 , Peter Baptista  6   7
Affiliations

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

Carlos Francia et al. Healthcare (Basel). .

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.

Keywords: DISE; OSA; epiglottis collapse.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
AP primary collapse with rigid component (trapdoor).
Figure 2
Figure 2
Examples of AP primary collapse with hyperlax epiglottis (floppy).
Figure 3
Figure 3
Examples of Lateral– Lateral (LL) primary collapse with omega-shape epiglottis (book type).
Figure 4
Figure 4
Secondary epiglottic collapse due to tongue base (a) or lateral pharyngeal walls collapse (b).
See this image and copyright information in PMC

References

    1. Peppard P.E., Young T., Barnet J.H., Palta M., Hagen E.W., Hla K.M. Increased prevalence of sleep-disordered breathing in adults. Am. J. Epidemiol. 2013;177:1006–1014. doi: 10.1093/aje/kws342. - DOI - PMC - PubMed
    1. Heinzer R., Vat S., Marques-Vidal P., Marti-Soler H., Andries D., Tobback N., Mooser V., Preisig M., Malhotra A., Waeber G., et al. Prevalence of sleep-disordered breathing in the general population: The HypnoLaus study. Lancet Respir. Med. 2015;3:310–318. doi: 10.1016/S2213-2600(15)00043-0. - DOI - PMC - PubMed
    1. Osman A.M., Carter S.G., Carberry J.C., Eckert D.J. Obstructive sleep apnea: Current perspectives. Nat. Sci. Sleep. 2018;10:21. doi: 10.2147/NSS.S124657. - DOI - PMC - PubMed
    1. Strollo P.J., Rogers R. Obstructive sleep apnea. N. Engl. J. Med. 1996;334:99–104. doi: 10.1056/NEJM199601113340207. - DOI - PubMed
    1. Young T., Palta M., Dempsey J., Skatrud J., Weber S., Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N. Engl. J. Med. 1993;328:1230–1235. doi: 10.1056/NEJM199304293281704. - DOI - PubMed

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