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Concentric versus anteroposterior-laterolateral collapse of the soft palate in patients with obstructive sleep apnea

E Van de Perck, C Heiser, O M Vanderveken
ERJ Open Research 2021 7: 71; DOI: 10.1183/23120541.sleepandbreathing-2021.71
E Van de Perck
1Antwerp University Hospital, Edegem, Belgium
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C Heiser
2Rechts der Isar Hospital, Munich, Germany
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O M Vanderveken
1Antwerp University Hospital, Edegem, Belgium
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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.

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  • ENT (Ears
  • Nose and Throat) aspects of sleep-disordered breathing
  • Obstructive sleep apnoea
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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).

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Concentric versus anteroposterior-laterolateral collapse of the soft palate in patients with obstructive sleep apnea
E Van de Perck, C Heiser, O M Vanderveken
ERJ Open Research Apr 2021, 7 (suppl 7) 71; DOI: 10.1183/23120541.sleepandbreathing-2021.71

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Concentric versus anteroposterior-laterolateral collapse of the soft palate in patients with obstructive sleep apnea
E Van de Perck, C Heiser, O M Vanderveken
ERJ Open Research Apr 2021, 7 (suppl 7) 71; DOI: 10.1183/23120541.sleepandbreathing-2021.71
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