[Predictive value of laryngoscopy with reference to the severity of obstructive sleep apnea]

The diagnosis of sleep-related breathing disorders is based primarily upon targeted history-taking and upon night-time polysomnography. Diagnostic measures should be completed by laryngopharyngoscopy (LPS). Frequently in cases of relevant obstructive sleep-related breathing disorders, a collapse of the pharyngeal lumen may be detected already in the waking state: either during spontaneous breathing or through adequate provocation (snoring manoeuvre). Furthermore, endoscopy of the upper airways will yield indirect clues as to nocturnal snoring and possible obstructive apnoeas. Although the predictive value of LPS regarding the degree of obstructive sleep-related breathing disorders seems low compared with polysomnography, it appears reasonable to perform it to exclude further relevant ENT findings. With LPS, local and regional obstacles of the kind of the intended positive pressure ventilation (narrowing of the nasal ducts, septum deviation and hyperplasia of the turbinates) are demonstrable which may warrant surgical correction. LPS, which has a low complication rate, facilitates interdisciplinary cooperation in the care for patients suffering from obstructive sleep-related breathing disorders.