Madeline J L Ravesloot1, Nico de Vries. 1. Department of Otolaryngology-Head and Neck Surgery, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands. m.ravesloot@slaz.nl
Abstract
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.
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.
Authors: Alonço da Cunha Viana; Daniella Leitão Mendes; Lucas Neves de Andrade Lemes; Luiz Claudio Santos Thuler; Denise Duprat Neves; Maria Helena de Araújo-Melo Journal: Eur Arch Otorhinolaryngol Date: 2016-05-10 Impact factor: 2.503
Authors: Michael Herzog; Sebastian Plößl; Alexander Glien; Beatrice Herzog; Christian Rohrmeier; Thomas Kühnel; Stefan Plontke; Patrick Kellner Journal: Sleep Breath Date: 2014-11-27 Impact factor: 2.816