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One hundred consecutive patients undergoing drug-induced sleep endoscopy: Results and evaluation

✍ Scribed by Madeline J. L. Ravesloot; Nico de Vries


Book ID
102453300
Publisher
John Wiley and Sons
Year
2011
Tongue
English
Weight
120 KB
Volume
121
Category
Article
ISSN
0023-852X

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✦ Synopsis


Objectives/Hypothesis: Polysomnography (PSG) is mandatory in the diagnostic workup of obstructive sleep apnea (OSA); drug-induced sleep endoscopy (DISE) is a valid addition. DISE is a dynamic, safe, easy-to-perform technique that visualizes the anatomic sites of snoring or apneas and guides the making of a tailor-made treatment plan in individual cases. The aim of this prospective study was to document the results of 100 consecutive DISE procedures and investigate associations between PSG and DISE findings.

Study Design: This prospective, single-center, observational study enrolled 100 consecutive patients between June and August 2010.

Methods: All 100 patients eligible for sleep surgery or a mandibular repositioning appliance (MRA) underwent PSG and DISE (using midazolam or propofol). DISE findings were reported using the VOTE classification system; site, degree of airway narrowing, and configuration of obstruction were reported. Associations were analyzed between PSG results, patient characteristics, and DISE findings.

Results: Our results suggest that a multilevel collapse, a complete collapse, and a tongue-base collapse are statistically significantly associated with higher apnea hypopnea index values. A tongue base collapse or epiglottal collapse is associated with positional OSA. Complete concentric collapse is statistically significantly associated with an increased body mass index.

Conclusions: The results of this small-scale study help us understand the pathogenesis of OSA and the various associations between PSG outcomes and DISE results, as well as assisting the sleep surgeon in tailoring surgery for the patient.