Drug‐Induced Sleep Endoscopy Upper Airway Collapse Patterns and Maxillomandibular Advancement

2020 ◽  
Vol 130 (4) ◽  
Author(s):  
Chloé Kastoer ◽  
Sara Op de Beeck ◽  
Marc Dom ◽  
Thérèse Neirinckx ◽  
Johan Verbraecken ◽  
...  
Keyword(s):  
Upper Airway ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Drug Induced Sleep Endoscopy ◽  
Maxillomandibular Advancement ◽  
Airway Collapse ◽  
Upper Airway Collapse

scholarly journals Comparison of Drug-Induced Sleep Endoscopy and Natural Sleep Endoscopy in the Assessment of Upper Airway Pathophysiology During Sleep: Protocol and Study Design

2021 ◽  
Vol 12 ◽  
Author(s):  
Karlien Van den Bossche ◽  
Eli Van de Perck ◽  
Andrew Wellman ◽  
Elahe Kazemeini ◽  
Marc Willemen ◽  
...  
Keyword(s):  
Gold Standard ◽  
Upper Airway ◽  
Diagnostic Methods ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Natural Sleep ◽  
Non Invasive ◽  
Drug Induced Sleep Endoscopy ◽  
Airway Collapse ◽  
Upper Airway Collapse

Study Objectives: Obstructive sleep apnea (OSA) is increasingly recognized as a complex and heterogenous disorder. As a result, a “one-size-fits-all” management approach should be avoided. Therefore, evaluation of pathophysiological endotyping in OSA patients is emphasized, with upper airway collapse during sleep as one of the main features. To assess the site(s) and pattern(s) of upper airway collapse, natural sleep endoscopy (NSE) is defined as the gold standard. As NSE is labor-intensive and time-consuming, it is not feasible in routine practice. Instead, drug-induced sleep endoscopy (DISE) is the most frequently used technique and can be considered as the clinical standard. Flow shape and snoring analysis are non-invasive measurement techniques, yet are still evolving. Although DISE is used as the clinical alternative to assess upper airway collapse, associations between DISE and NSE observations, and associated flow and snoring signals, have not been quantified satisfactorily. In the current project we aim to compare upper airway collapse identified in patients with OSA using endoscopic techniques as well as flow shape analysis and analysis of tracheal snoring sounds between natural and drug-induced sleep.Methods: This study is a blinded prospective comparative multicenter cohort study. The study population will consist of adult patients with a recent diagnosis of OSA. Eligible patients will undergo a polysomnography (PSG) with NSE overnight and a DISE within 3 months. During DISE the upper airway is assessed under sedation by an experienced ear, nose, throat (ENT) surgeon using a flexible fiberoptic endoscope in the operating theater. In contrast to DISE, NSE is performed during natural sleep using a pediatric bronchoscope. During research DISE and NSE, the standard set-up is expanded with additional PSG measurements, including gold standard flow and analysis of tracheal snoring sounds.Conclusions: This project will be one of the first studies to formally compare collapse patterns during natural and drug-induced sleep. Moreover, this will be, to the authors' best knowledge, the first comparative research in airflow shape and tracheal snoring sounds analysis between DISE and NSE. These novel and non-invasive diagnostic methods studying upper airway mechanics during sleep will be simultaneously validated against DISE and NSE.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04729478.

scholarly journals Drug-Induced Sleep Endoscopy: Clinical Application and Surgical Outcomes

Healthcare ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 100 ◽  
Author(s):  
Vito ◽  
Cammaroto ◽  
Chong ◽  
Carrasco-Llatas ◽  
Vicini
Keyword(s):  
Surgical Outcomes ◽  
Acoustic Analysis ◽  
Three Dimensional ◽  
Upper Airway ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Drug Induced Sleep Endoscopy ◽  
Therapeutic Decision Making ◽  
Open Question ◽  
Insight Into

The visualization of the level and pattern of apnea and hypopnea events is of pivotal importance in the diagnosis and therapeutic decision-making for sleep-disordered breathing (SDB). There are numerous techniques available to assess upper airway obstruction, which include imaging, acoustic analysis, pressure transducer recording, and endoscopic evaluation. Drug-induced sleep endoscopy (DISE) is a diagnostic tool that allows the dynamic, three-dimensional evaluation of the patterns of vibration and collapse of the upper airway of SDB patients. DISE may change the initial surgical planning in a high percentage of cases. A universally accepted and methodologically standardized DISE could provide significant insight into its role to improve surgical outcomes. However, up to now the ideal DISE protocol remains an open question.

scholarly journals Application of drug-induced sleep endoscopy in patients treated with upper airway stimulation therapy

2017 ◽  
Vol 3 (2) ◽  
pp. 92-96 ◽  
Author(s):  
Adrian A. Ong ◽  
Christopher M. Ayers ◽  
Eric J. Kezirian ◽  
B. Tucker Woodson ◽  
Nico de Vries ◽  
...  
Keyword(s):  
Upper Airway ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Upper Airway Stimulation ◽  
Drug Induced Sleep Endoscopy

scholarly journals Patogenesis dan diagnosis gangguan napas saat tidur dengan Drug Induce Sleep Endoscopy (DISE)

2018 ◽  
Vol 47 (2) ◽  
pp. 193
Author(s):  
Elvie Zulka Kautzia Rachmawati ◽  
Wresty Arief ◽  
Susyana Tamin ◽  
Rahmanofa Yunizaf ◽  
Fauziah Fardizza
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Upper Airway ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Drug Induced Sleep Endoscopy ◽  
Obstructive Sleep ◽  
Muller’S Maneuver

Latar belakang: Obstructive sleep apnea (OSA) ialah penyakit kronis yang terjadi akibat episode intermiten sumbatan jalan napas komplit atau sebagian saat tidur. OSA dapat menimbulkan komplikasi seperti hipertensi, diabetes melitus, stroke dan excessive daytime sleepiness yang dapat berakibat fatal. OSA merupakan bagian dari gangguan napas saat tidur. Tujuan: Mengindentifikasi letak atau level dan konfigurasi sumbatan pada saat tidur. Tinjauan pustaka: Cara untuk mendiagnosis OSA adalah nasofaringolaringoskopi dengan Muller`s maneuver, pemeriksaan polisomnography (PSG), dan drug induce sleep endoscopy (DISE). Pemeriksaan PSG merupakan standar baku emas untuk mendapakan nilai apnea-hipopnea index (AHI) yang menentukan derajat OSA. Pemeriksaan untuk mengidentifikasi lokasi sumbatan jalan napas yang menyebabkan peningkatan resistensi aliran udara adalah Muller`s maneuver dan DISE. Pada pemeriksaan DISE, digunakan propofol atau midazolam secara intravena untuk menstimulasi keadaan sumbatan pada saat tidur, dilanjutkan dengan pemeriksaan nasofaringolaringoskopi. Kesimpulan: Pemeriksaan ini merupakan cara yang sangat terpercaya untuk menentukan level sumbatan pada keadaan tidur, sehingga jenis tindakan operasi yang dilakukan menjadi lebih tepat. Kata kunci: Drug induced sleep endoscopy, midazolam, propofol, manuver Muller’s, obstructive sleep apnea, polisomnografi  ABSTRACT Background: Obstructive sleep apnea (OSA) is a common chronic disorder caused by intermittent episodes of complete or partial upper airway obstruction during sleep. It may lead to complications such as hypertension, diabetes mellitus, stroke, as well as excessive daytime sleepiness which can be fatal. OSA is a part of sleep disorder breathing. Purpose: To identify the sites or the levels of obstruction and its configuration. Literature review: Muller’s maneuver upon nasopharyngoscopy, polysomnography (PSG), and drug-induced sleep endoscopy (DISE) are the modalities for diagnosing OSA. Polysomnography is the gold standard examination for OSA, one of the variables; the apnea-hipopnea index (AHI) is used to determine the presence and severity of OSA. Muller’s maneuver and DISE are the examination to identify the sites responsible for increase in airflow resistance. DISE technique uses intravena injection of propofol or midazolam to produce obstruction in a “natural sleep” condition followed by nasopharyngolaryngoscopy examination. Conclusion: DISE is considered as a very reliable means to define the level of obstruction during sleeping, thus could help to determine appropriate surgery. Keywords: Drug induced sleep endoscopy, midazolam, propofol, Muller’s maneuver, obstructive sleep apnea, polisomnography

Awake endoscopic assessment of the upper airway during tidal breathing: Definition of anatomical features and comparison with drug‐induced sleep endoscopy

2020 ◽  
Vol 46 (1) ◽  
pp. 234-242
Author(s):  
Eli Van de Perck ◽  
Anneclaire V. Vroegop ◽  
Sara Op de Beeck ◽  
Marijke Dieltjens ◽  
Annelies E. Verbruggen ◽  
...  
Keyword(s):  
Upper Airway ◽  
Sleep Endoscopy ◽  
Tidal Breathing ◽  
Drug Induced ◽  
Anatomical Features ◽  
Drug Induced Sleep Endoscopy ◽  
Definition Of ◽  
Endoscopic Assessment
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