Drug induced sleep endoscopy – does a local fi nding in the upper respiratory tract correspond to the severity of sleep apnea syndrome?

2021 ◽  
Vol 84/117 (2) ◽  
Author(s):  
Jiří Kalhous ◽  
Jan Kordík
Keyword(s):  
Sleep Apnea ◽  
Respiratory Tract ◽  
Sleep Apnea Syndrome ◽  
Upper Respiratory Tract ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Drug Induced Sleep Endoscopy ◽  
Upper Respiratory ◽  
Apnea Syndrome

scholarly journals Non-acid reflux and sleep apnea: the importance of drug induced sleep endoscopy

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Carlos O’Connor-Reina ◽  
Jose Maria Ignacio Garcia ◽  
Peter Baptista ◽  
Maria Teresa Garcia-Iriarte ◽  
Carlos Casado Alba ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Reflux Disease ◽  
Sleep Apnea Syndrome ◽  
Acid Reflux ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Drug Induced Sleep Endoscopy ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Abstract Background We present the first case of a patient with obstructive sleep apnea syndrome (OSA), where drug induced sleep endoscopy was helpful to suspect a non-acid reflux disease and showed an improvement in a swollen epiglottis after treatment. Patient ameliorated significantly his disease only with medical therapy. Case presentation A 54-year-old man without significant anatomical findings with obstructive sleep apnea syndrome and non-acid gastroesophageal reflux disease (GERD) disease whose Apnea- hypopnea index (AHI) was significantly reduced with the intake of 500 mg of sodium alginate twice a day for 6 months. Conventional digestive tests such as esophagoscopy and simple- and double-channel 24-h pH-metry suggested mild GERD. Conventional proton-pump inhibitor treatment with pantoprazole (40 mg daily) was started without any improvement in his sleep. Multichannel intraluminal 24-h impedanciometry indicated the presence of severe pathological GER of gaseous origin. The patient’s AHI decreased from 25.3 at baseline to 8 after treatment with sodium alginate. A drug-induced sleep endoscopy study showed the changes before and after this treatment and was helpful for the diagnosis. Conclusions Thus, medical treatment can be a therapeutic option in some patients with OSA. Multichannel 24-h impedanciometry should be performed when nonacid GERD is suspected.

scholarly journals Comparison of Findings between Clinical Examinations and Drug-Induced Sleep Endoscopy in Patients with Obstructive Sleep Apnea Syndrome

2020 ◽  
Vol 17 (17) ◽  
pp. 6041
Author(s):  
Huan-Yu Lin ◽  
Yi-Chih Lin ◽  
Ying-Shuo Hsu ◽  
Liang-Chun Shih ◽  
Tyler Nelson ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Staging System ◽  
Tongue Base ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Drug Induced Sleep Endoscopy ◽  
Obstructive Sleep ◽  
Physical Examinations

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.

Drug-Induced Sleep Endoscopy with Target-Controlled Infusion Using Propofol in the Management of Patients with Obstructive Sleep Apnea

2018 ◽  
Vol 69 (6) ◽  
pp. 1431-1434
Author(s):  
Dragos Cristian Stefanescu ◽  
Razvan Hainarosie ◽  
Viorel Zainea
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Mandibular Advancement ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Multicenter Studies ◽  
Drug Induced Sleep Endoscopy ◽  
Target Controlled Infusion ◽  
Obstructive Sleep

Although it seems to be an exhausted subject at first glance, the therapeutic approach in obstructive sleep apnea syndrome (O.S.A.S.) is still an open subject. The continuous positive airway pressure (C.P.A.P.) represents the gold standard of therapy in O.S.A.S. However, this therapeutic process with C.P.A.P. has a low rate of compliancy, over 50% of patients quit in the first year of use. Implicitly, surgical solutions or mandibular advancement devices remain an alternative for many of these patients. High costs, complexity and risks associated with surgery have led to the identification of more accurate methods for topographic and functional diagnosis in O.S.A.S. Drug-induced sleep endoscopy (D.I.S.E.) with target-controlled infusion (T.C.I.) using propofol in the management of patients with obstructive sleep apnea is a relatively recently introduced method in Romania. The present paper describes our experience with D.I.S.E for selected patients, who have undergone surgery on the upper airway for O.S.A.S. The D.I.S.E method has led to the modification of the initial surgical plan in over 60% of patients with multi-level obstruction. Under these conditions, the surgical success rate in patients of the study increased to 80% at 6 months. Considering the specific endowment of each tertiary sleep center, the presence or absence of an operator block and the anesthetist�s experience with target-controlled (T.C.I.) infusion using propofol, more extensive and multicenter studies are needed for standardization of D.I.S.E.

scholarly journals Drug Induced Sleep Endoscopy for Obstructive Sleep Apnea Syndrome: An Initial Experience in a Tertiary Level Centre

2019 ◽  
Vol 41 (3) ◽  
pp. 83-85
Author(s):  
Bashu D Parajuli ◽  
Lokendra Mandal ◽  
Megha Koirala ◽  
Amit S Bhattarai ◽  
Yogesh Neupane ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Anaesthetic Agents ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Drug induced sleep endoscopy (DISE) is a technique of performing endoscopy of the upper airway after inducing sleep by the use of anaesthetic agents in patients suffering from obstructive sleep apnea syndrome (OSAS). The main purpose of DISE is to detect the obstruction or collapse at one or more location in the upper airway, both for the successful diagnosis and management of OSAS. Here we discuss a case of OSAS who underwent DISE under novel anaesthetic agents midazolam and dexmedetomidine.

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