PT  - JOURNAL ARTICLE
AU  - Van de Perck, E
AU  - Heiser, C
AU  - Vanderveken, O M
TI  - Concentric versus anteroposterior-laterolateral collapse of the soft palate in patients with obstructive sleep apnea
AID  - 10.1183/23120541.sleepandbreathing-2021.71
DP  - 2021 Apr 16
TA  - ERJ Open Research
PG  - 71
VI  - 7
IP  - suppl 7
4099  - http://openres.ersjournals.com/content/7/suppl_7/71.short
4100  - http://openres.ersjournals.com/content/7/suppl_7/71.full
SO  - erjor2021 Apr 16; 7
AB  - 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.FootnotesCite 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).