Use of Muller's maneuver in the evaluation of patients with sleep apnea: literature review

Sleep apnea-hypopnea syndrome was described twenty years ago, and since then there have been doubts and controversies regarding it. Fiberoptic nasopharyngoscopy with Muller's maneuver, first described by Borowieck and Sassin (1983), is among them. AIM: Careful literature review on Muller's maneuver, regarding whether it can predict the sucess of uvulopalatopharyngoplasty, location of upper airway obstruction and severity of the disorder. DISCUSSION AND LITERATURE REWIEW: Literature has shown that there isn't a consensus about the use of Muller's maneuver. In spite of being technically easy, inexpensive and widely used, it is very unespecific and subjective. CONCLUSION: The importance of Muller's maneuver in evaluating apneic patients has been questioned, because there are controversies whether it can predict the sucess of uvulopalatopharyngoplasty, location of upper airway obstruction and severity of the disease.

[1]  M. Friedman,et al.  Does Severity of Obstructive Sleep Apnea/Hypopnea Syndrome Predict Uvulopalatopharyngoplasty Outcome? , 2005, The Laryngoscope.

[2]  C. Maas,et al.  The predictive efficacy of the müller maneuver in uvulopalatopharyngoplasty , 1989, The Laryngoscope.

[3]  E D Robin,et al.  Extreme obesity associated with alveolar hypoventilation--a Pickwickian Syndrome. 1956. , 1956, Obesity research.

[4]  J. Piccirillo,et al.  The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. , 1996, Sleep.

[5]  A J Block,et al.  Sleep apnea, hypopnea and oxygen desaturation in normal subjects. A strong male predominance. , 1979, The New England journal of medicine.

[6]  M. Friedman,et al.  Staging of Obstructive Sleep Apnea/Hypopnea Syndrome: A Guide to Appropriate Treatment , 2004, The Laryngoscope.

[7]  P. L. Smith,et al.  CT demonstration of pharyngeal narrowing in adult obstructive sleep apnea. , 1983, AJR. American journal of roentgenology.

[8]  K. Doghramji,et al.  Predictors of outcome for uvulopalatopharyngoplasty , 1995, The Laryngoscope.

[9]  J. H. Auchincloss,et al.  Clinical and physiological aspects of a case of obesity, polycythemia and alveolar hypoventilation. , 1955, The Journal of clinical investigation.

[10]  Luisa Grymer,et al.  Available Techniques for Objective Assessment of Upper Airway Narrowing in Snoring and Sleep Apnea , 2003, Sleep and Breathing.

[11]  A C Bryan,et al.  Upper airway morphology in patients with idiopathic obstructive sleep apnea. , 2015, The American review of respiratory disease.

[12]  J. Remmers,et al.  Chapter 101 – Anatomy and Physiology of Upper Airway Obstruction , 2011 .

[13]  H. Gastaut,et al.  Polygraphic study of the episodic diurnal and nocturnal (hypnic and respiratory) manifestations of the Pickwick syndrome. , 1966, Brain research.

[14]  M. Hanasono,et al.  Reliability of the Muller Maneuver and Its Association With Sleep‐Disordered Breathing , 2000, The Laryngoscope.

[15]  M. Badr.  Pathophysiology of upper airway obstruction during sleep. , 1998, Clinics in chest medicine.

[16]  R. Shprintzen,et al.  Predictive value of müuller maneuver in selection of patients for uvulopalatopharyngoplasty , 1985, The Laryngoscope.

[17]  G. Maislin,et al.  Quantitative evaluation of the upper airway during nasopharyngoscopy with the müller maneuver , 1999, The Laryngoscope.

[18]  J. Sassin,et al.  Surgical treatment of sleep apnea. , 1983, Archives of otolaryngology.

[19]  C. Guilleminault,et al.  Snoring, and some obstructive sleep apnea, can be cured by oropharyngeal surgery. , 1983, Archives of otolaryngology.

[20]  R. Jung,et al.  NEUROPHYSIOLOGICAL STUDIES OF ABNORMAL NIGHT SLEEP AND THE PICKWICKIAN SYNDROME. , 1965, Progress in brain research.

[21]  N J Douglas,et al.  The sleep hypopnea syndrome. , 1988, The American review of respiratory disease.

[22]  Hani Ibrahim,et al.  Clinical Staging for Sleep-Disordered Breathing , 2002, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[23]  T. Roth,et al.  Surgical Correction of Anatomic Abnormalities in Obstructive Sleep Apnea Syndrome: Uvulopalatopharyngoplasty , 1981, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[24]  P. Suadicani,et al.  Predictive value of Müller maneuver, cephalometry and clinical features for the outcome of uvulopalatopharyngoplasty. Evaluation of predictive factors using discriminant analysis in 30 sleep apnea patients. , 1994, Acta oto-laryngologica.

[25]  T. Verse,et al.  Long-term results in the treatment of obstructive sleep apnea , 2000, European Archives of Oto-Rhino-Laryngology.

[26]  P. Rombaux,et al.  Standard ENT clinical evaluation of the sleep-disordered breathing patient; a consensus report. , 2002, Acta oto-rhino-laryngologica Belgica.

[27]  Scott S. Campbell,et al.  Enhanced performance in elderly subjects following bright light treatment of sleep maintenance insomnia , 1996, Journal of sleep research.

[28]  O. Hilberg,et al.  Flextube reflectometry for localization of upper airway narrowing--a preliminary study in models and awake subjects. , 2001, Respiratory Medicine.

[29]  W C Dement,et al.  The sleep apnea syndromes. , 1976, Annual review of medicine.

[30]  A I Pack,et al.  Dynamic upper airway imaging during awake respiration in normal subjects and patients with sleep disordered breathing. , 1993, The American review of respiratory disease.

[31]  R. Daroff,et al.  The International Classification of Sleep Disorders , 1991, Neurology.