{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:06:29Z","timestamp":1790024789722,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T00:00:00Z","timestamp":1590796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100008108","name":"Taipei Tzu Chi Hospital","doi-asserted-by":"publisher","award":["TCRD\u2010TPE\u2010108\u201026"],"award-info":[{"award-number":["TCRD\u2010TPE\u2010108\u201026"]}],"id":[{"id":"10.13039\/501100008108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>This study aimed to assess the role of capnography in objectively evaluating breathing routes during drug\u2010induced sleep endoscopy (DISE) and further elucidate the relationship between breathing route, obstructive sleep apnea (OSA) severity, and DISE findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Nighty\u2010five patients with established OSA were recruited for this study from May 2017 to May 2019. DISE was performed in the operating room. Sedation was maintained with propofol using a target\u2010controlled infusion system and the depth of sedation was monitored based on the bispectral index. The breathing routes, which included oral breathing, oronasal breathing, and nasal breathing, were detected using capnography. DISE findings were recorded using the VOTE (velum, oropharynx, base of tongue, and epiglottis) classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with mouth breathing were associated with increased OSA severity, worse oximetric variables, and higher body mass index in comparison with those with other breathing routes. Mouth breathing was associated with a higher degree and higher prevalence of lateral pharyngeal wall collapse and tongue base collapse during DISE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mouth breathing was significantly associated with worse oxygen desaturation and increased degree of upper airway collapse. Therefore, patients with mouth breathing during propofol\u2010based intravenous anesthesia should be carefully monitored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:E659\u2013E664, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28774","type":"journal-article","created":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T18:24:36Z","timestamp":1590863076000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Association Between Breathing Route, Oxygen Desaturation, and Upper Airway Morphology"],"prefix":"10.1002","volume":"131","author":[{"given":"Yen\u2010Bin","family":"Hsu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"School of Medicine National Yang\u2010Ming University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5565-9580","authenticated-orcid":false,"given":"Ming\u2010Ying","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"School of Medicine National Yang\u2010Ming University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun\u2010Chen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation  New Taipei Taiwan"},{"name":"School of Medicine Tzu Chi University  Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Chang","family":"Kao","sequence":"additional","affiliation":[{"name":"School of Medicine Tzu Chi University  Hualien Taiwan"},{"name":"Department of Anesthesiology Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9979-3260","authenticated-orcid":false,"given":"Ming\u2010Chin","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation  New Taipei Taiwan"},{"name":"School of Medicine Tzu Chi University  Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-2905"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-013-0991-2"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.136"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.09.006"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000053"},{"key":"e_1_2_6_7_1","first-page":"97","article-title":"The upper airways. 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