The Role of Drug-induced Sleep Endoscopy in Treatment (Surgical and Non-surgical) in Patients with Obstructive Sleep Apnea

2017 ◽  
Vol 80/113 (4) ◽  
pp. 428-433
Author(s):  
Jaroslava Hybášková ◽  
Ondřej Jor ◽  
Vilém Novák ◽  
Petr Matoušek ◽  
Pavel Komínek
Author(s):  
Crystal SJ Cheong ◽  
Weiqiang Loke ◽  
Mark Kim Thye Thong ◽  
Song Tar Toh ◽  
Chi-Hang Lee

Obstructive sleep apnea is a prevalent sleep disorder characterized by partial or complete obstruction of the upper airway. Continuous positive airway pressure is the first-line therapy for most patients, but compliance is often poor. Alternative treatment options such as mandibular advancement devices, positional therapy and surgical interventions including upper airway stimulation target different levels and patterns of obstruction with varying degrees of success. Drug-induced sleep endoscopy enables visualization of upper airway obstruction under conditions mimicking sleep. In an era of precision medicine, this additional information may facilitate better decision-making when prescribing alternative treatment modalities, with the hope of achieving better compliance and/or success rates. This review discusses the current knowledge and evidence on the role of drug-induced sleep endoscopy in the non-positive airway pressure management of obstructive sleep apnea.


Author(s):  
Huan-Yu Lin ◽  
Yi-Chih Lin ◽  
Ying-Shuo Hsu ◽  
Liang-Chun Shih ◽  
Tyler Nelson ◽  
...  

The Velum, Oropharynx, Tongue base and Epiglottis (VOTE) classification on drug-induced sleep endoscopy (DISE) is used widely for obstructive sleep apnea (OSA) syndrome, though research into comparative physical examinations with VOTE on DISE is still limited. The aim of this study was to evaluate the relationship between the findings of physical examinations and DISE in patients with OSA. Fifty-five patients with OSA were enrolled in this retrospective study. All of the patients received clinical explorations including a Brodsky classification, a modified Mallampati score (MMS), a modified Friedman’s staging system, and a Muller’s test. Drug-induced sleep endoscopy was further evaluated in the operating room. There were significant relationships between Brodsky classification, modified Friedman’s staging system, Muller’s test and oropharynx collapse during DISE (p < 0.05). Brodsky classification, MMS, modified Friedman’s staging system and retropalatal lateral-to-lateral (L–L) collapse of Muller’s test were significantly correlated with VOTE count (p < 0.05). The concordance between VOTE under DISE and Brodsky classification or modified Friedman’s staging system was moderate. In contrast, the concordance between VOTE under DISE and MMS or Muller’s test was slight. The study revealed that Brodsky classification and Friedman staging had a significant relationship with DISE on the velum and oropharynx, but the level of tongue base is uncertain between DISE and MMS. Correlation of awake evaluation of tongue base is still not correlated to the DISE findings. Pre-treatment evaluation of DISE is still warranted.


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