Cardiovascular Medicine Book

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Muller Maneuver

Aka: Muller Maneuver
  1. See Also
    1. Obstructive Sleep Apnea
    2. Valsalva Maneuver
    3. Pneumomediastinum
  2. Indications
    1. Obstructive Sleep Apnea evaluation
      1. Identify areas of Bronchial tree collapse (examiner observes with scope inserted during maneuver)
      2. May determine whether patient will benefit from Uvulopalatopharyngoplasty (UPPP)
        1. However, non-specific and questionable utility
        2. Soares (2009) Braz J Otorhinolaryngol 75(3):463-6 +PMID:19649500 [PubMed]
    2. Explains mechanism of inhalational injury (e.g. inhalational drug use)
      1. Inhalation Drug Users may perform similar maneuver when Huffing, resulting in Pneumomediastinum
  3. Technique
    1. Patient first performs forceful expiration
    2. Patient attempts full inspiration against a closed mouth and nose
      1. Creates a negative pressure within the chest and lungs
      2. Opposite the Valsalva Maneuver (which is instead, forced expiration against closed nose and mouth)
  4. Complications
    1. Pneumomediastinum

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