gms | German Medical Science

Introduction: Esophagopharyngeal pressure measurements are helpful in the differentiation of obstructive respiratory events by measuring the esophageal pressure during polysomnography. In addition the localization of snoring and obstructive respiratory events is possible with multichannel pharyngeal pressure measurement. Advantages and limitations of this method will be explained by an experience period of 5 years.

Methods: Between 2000 and 2005 esophagopharyngeal pressure measurements were done during nocturnal polysomnography in 96 patients with suspected obstructive sleep apnea syndrome. Only 6 patients (7%) did not tolerate the pressure probe. A specially developed, computer-based software allowed us to analyse the data manually and automatically for each separate channel.

Results: Without disruption of the physiological sleep architecture an increase of the esophageal pressure was found with increasing depth of sleep. Esophageal pressure correlated well with the respiratory disturbance index but prediction of the sufficient CPAP-pressure was not possible. 82 patients (91%) showed a highfrequent snoring signal with localization in the velar region (73%), multilevel snoring was shown in 58 patients (64%). Success-rate of laser-assisted uvulopalatoplasty (LAUP) increased by preoperative measurement of esophagopharyngeal pressure. But analysis of the region of obstruction is difficult, however a velar region of obstruction was found in 65 patients (72%). In these patients the operative success-rate of tonsillectomy with uvulopalatopharyngoplasty (UPPP) could not be increased by additional preoperative esophagopharyngeal pressure measurement.

Conclusions: The most important value of esophagopharyngeal pressure measurement consists in the preoperative diagnosis of snoring patients. The method is limited by high financial and personal requirements.