Drug-induced sleep endoscopy – decisional factor in obstructive sleep apnea treatment

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Abstract

BACKGROUND. Drug-Induced Sleep Endoscopy (DISE) is a sleep apnea diagnostic procedure which allows direct view the obstruction while inducing sleep using analgosedation with propofol. Many studies highlighted the importance of DISE in finding the level of obstruction and choosing the specific treatment.

MATERIAL AND METHODS. We performed DISE under propofol sedation in 27 patients diagnosed with sleep apnea who addressed to our clinic for further investigation and treatment. We assessed the obstruction type and severity using the Fujita scale, VOTE (velum, oropharynx, tongue base, epiglottis) and NOHL (nose, oropharynx, hypopharynx, larynx). Finally, we correlated the DISE findings with the polysomnographic results.

RESULTS. We observed significant correlations between the obstruction severity seen at DISE and the polysomnographic results. Further, we could decide the appropriate treatment for our patients, whether surgical or not (continuous positive airway pressure - CPAP).

CONCLUSION. Sleep endoscopy represents a very important method in establishing the topographic diagnostic of sleep apnea patients, being useful for the therapeutic decision and the postoperative assessment. We recommend drug-induced sleep endoscopy as elective investigation regarding the diagnostic and treatment of sleep apnea patients.

1. Shamsuzzaman AS, Gersh BJ, Somers VK. Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA. 2003;290(14):1906–14.

2. George CF, Smiley A. Sleep apnea and automobile crashes. Sleep. 1999;22(6):790–5.

3. Passali FM, Marzetti A, Bellussi L, Passali D. The diagnosis of obstructive sleep apnea syndrome. Romanian Journal of Rhinology. 2013;3(12):195-202.

4. Peverini F, Passali FM, Passali D. The role of polysomnography in OSAS patients. Romanian Journal of Rhinology. 2013;3(12):203-12.

5. De Vito A, Carrasco Llatas M, Vanni A, Bosi M, Braghiroli A, Campanini A, et al. European position paper on drug-induced sedation endoscopy (DISE). Sleep Breath. 2014;18(3):453-65. DOI: 10.1007/s11325-014-0989-6. Epub 2014 May 26.

6. Veer V, Zhang H, Beyers J, Vanderveken O, Kotecha B. The use of drug-induced sleep endoscopy in England and Belgium. Eur Arch Otorhinolaryngol. 2018;275(5):1335-42. DOI: 10.1007/s00405-018-4939-y. Epub 2018 Mar 19.

7. Borowiecki B, Pollak CP, Weitzman ED, Rakoff S, Imperato J. Fibrooptic study of pharyngeal airway during sleep in patients with hypersomnia obstructive sleep-apnea syndrome. Laryngoscope. 1978;88(8 Pt 1):1310–3.

8. Croft CB, Pringle M. Sleep nasendoscopy: a technique of assessment in snoring and obstructive sleep apnoea. Clin Otolaryngol Allied Sci. 1991;16(5):504–9.

9. Hessel NS, de Vries N. Diagnostic work-up of socially unacceptable snoring. II. Sleep endoscopy. Eur Arch Otorhinolaryngol. 2002;259(3):158–61.

10. den Herder C, van Tinteren H, de Vries N. Sleep endoscopy versus modified Mallampati score in sleep apnea and snoring. Laryngoscope. 2005;115(4):735–9.

11. Hohenhorst W, Ravesloot MJL, Kezirian EJ, de Vries N. Drug induced sleep endoscopy in adults with sleep-disordered breathing: technique and the VOTE classification system. Oper Tech Otolaryngol Head Neck Surg. 2012;23(1):11–8. DOI: 10.1016/j.otot.2011.06.001.

12. Koutsourelakis I, Safiruddin F, Ravesloot M, Zakynthinos S, de Vries N. Surgery for obstructive sleep apnea: sleep endoscopy determinants of outcome. Laryngoscope. 2012;122(11):2587–91. DOI: 10.1002/lary.23462. Epub 2012 Aug 1.v

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