Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4586_Библиотеки_им_академика_М_И_Перельмана

epiglottis is present in about 30–50% of infants, but is much less common in adults, as it becomes atter during growth [113, 114]. In a study by Li etal., it was estab­lished that spacing between the tongue base and epiglottis as assessed in the awake state in the supine position could predict glossopharyngeal obstructions detected with PSG and the nasopharyngeal tube inserted. The nding of obscured valleculae corre­lated well with some polysomnographic ndings (AHI, lowest saturation). However, their method did not allow for distinction between obstructions at the base of tongue and isolated epiglottis obstructions [115]. In a recently published study, the authors described how epiglottis shape correlates to obstructions at the level of the tongue base and epiglottis as assessed during the DISE.They have also proposed a classica­tion system based on epiglottis concavity as seen during the awake examination (Fig.6.6). In the group of patients with at epiglottises (type 3), obstructions at the level of the epiglottis and/or base of tongue—primary and secondary epiglottis col­lapse—occurred in most cases (94%) [116]. Another study analyzing the clinical characteristics of patients with isolated epiglottis collapse found a relation between such collapse and a shorter distance between mandible plane and hyoid, relative to the control group. However, no differences were observed between the two groups in terms of epiglottis shape or curvature, and the authors concluded that isolated epiglot­tic collapse could not be determined during awake endoscopy [30].