Abstract
Introduction: Complete concentric collapse of the soft palate (CCCp) is a formal exclusion criterion for upper airway stimulation therapy. However, given the complex anatomy of the soft palate, several collapse patterns might be mistaken for CCCp.
Aims: To evaluate whether CCCp and anteroposterior-laterolateral (AP-LL) collapse of the soft palate are two different endotypes.
Methods: Drug-induced sleep endoscopy (DISE) recordings of patients with OSA (n = 332) were reviewed to assess the collapse pattern of the soft palate (being anteroposterior, concentric, or AP-LL). Contrary to the sphincter-like shape of CCCp, AP-LL collapse was characterized by a triangular or rectangular configuration (Figure).
Results: Of the 194 cases with complete palatal collapse, 97 (50.0%) were categorized as anteroposterior, 68 (35.1%) as concentric, and 29 (14.9%) as AP-LL. Patients with complete AP-LL collapse had smaller neck circumferences (mean [SD]; 40.2 [2.7] vs 41.1 [2.9] cm) and less severe OSA (apnea-hypopnea index 20.2 [14.9] vs 29.5 [20.8] events/hour) than patients with CCCp. Among patients with AP-LL collapse, 19 (65.5%) were originally diagnosed with CCCp.
Conclusion: AP-LL collapse of the soft palate might represent a distinct endotype that is easily confounded with CCCp. Future research on the pathophysiology and therapeutic implications of both collapse patterns is warranted.
Footnotes
Cite this article as ERJ Open Research 2021; 7: Suppl. 7, 71.
This is an ERS Lung Science Conference abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021
