What is the best method to examine the upper airway in cases of obstructive sleep apnea (OSA)?

The best method to examine the upper airway in cases of obstructive sleep apnea (OSA) is nasal endoscopy. This technique allows direct visualization of the nasal passages, nasopharynx, and oropharynx, which are critical areas where obstructions may occur in patients with OSA.

Nasal endoscopy is advantageous because it provides real-time feedback, helping to identify anatomical abnormalities such as nasal polyps, turbinate hypertrophy, or other obstructions that can contribute to airway resistance during sleep. Additionally, the procedure is minimally invasive and can be performed in an office setting, making it accessible and effective for evaluating upper airway pathology.

While CT scans and magnetic resonance imaging can provide detailed anatomical images, they are not typically utilized for direct airway examination in the clinical setting of OSA. X-rays offer limited detail regarding soft tissue structures and are less informative for evaluating dynamic airway obstructions. Thus, nasal endoscopy stands out as the most effective method to assess the upper airway in patients suffering from obstructive sleep apnea.