The Impact of BMI on the Differences Between Drug‐Induced Sleep Endoscopy and Müller Maneuver

ABSTRACT Purpose To explore the differences in drug‐induced sleep endoscopy (DISE) and Müller Maneuver (MM) results and study the impact of body mass index (BMI) on these differences. Study Design Prospective observational study. Methods Forty patients with OSAHS were included in this study. All enrolled patients were evaluated for MM and DISE using the Velum, Oropharynx lateral walls, Tongue Base, and Epiglottis (VOTE) classification to describe the type, site, and degree of upper airway collapse. Results The differences between MM and DISE were statistically significant at the tongue base ( p < 0.001) and epiglottis levels ( p < 0.001). At the epiglottis level, the differences of identifying severe obstruction between DISE and MM were statistically significant in the BMI < 25 kg/m² ( p = 0.033) and BMI 25–30 kg/m² groups ( p = 0.049). But for the BMI ≥ 30 kg/m² group, the difference was not statistically significant ( p = 0.077). Conclusion DISE is more sensitive in detecting obstructions of OSAHS at the tongue base and epiglottis levels, especially in non‐obese patients. MM could be a reasonable alternative in obese OSAHS patients when DISE is not available.