Victor F Certal1,2, Rui Pratas2, Lidia Guimarães2, Rodolfo Lugo3, Yungan Tsou4, Macario Camacho5, Robson Capasso6. 1. CINTESIS (Center for Research in Health Technologies and Information Systems), University of Porto, Porto, Portugal. 2. Department of Otorhinolaryngology/Sleep Medicine Center, Hospital CUF and Hospital Sao Sebastiao, Porto, Portugal. 3. Department of Otorhinolaryngology, Grupo Medico San Pedro, Monterrey, Mexico. 4. Department of Otolaryngology, Division of Sleep Surgery and Medicine, China Medical University Hospital, Taichung, Taiwan. 5. Department of Otolaryngology, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, Honolulu, Hawaii. 6. Sleep Surgery Division, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A.
Abstract
OBJECTIVE: Traditionally, upper airway examination is performed while the patient is awake. However, in the past two decades, drug-induced sleep endoscopy (DISE) has been used as a method of tridimensional evaluation of the upper airway during pharmacologically induced sleep. This study aimed to systematically review the evidence regarding the usefulness of DISE compared with that of traditional awake examination for surgical decision making in patients with obstructive sleep apnea (OSA). DATA SOURCES: Scopus, PubMed, and Cochrane Library databases were searched. REVIEW METHODS: Only studies with a primary objective of evaluating the usefulness of DISE for surgical decision making in patients with OSA were selected. The included studies directly compared awake examination data with DISE outcome data in terms of possible influences on surgical decision making and operation success. RESULTS: A total of eight studies with 535 patients were included in this review. Overall, the surgical treatment changed after DISE in 50.24% (standard deviation 8.4) cases. These changes were more frequently associated with structures contributing to hypopharyngeal or laryngeal obstruction. However, these differences do not automatically indicate a higher success rate. CONCLUSION: This review emphasized the direct impact of DISE compared with that of awake examination on surgical decision making in OSA patients. However, it is also clear that the available published studies lack evidence on the association between this impact and surgical outcomes. Laryngoscope, 126:768-774, 2016.
OBJECTIVE: Traditionally, upper airway examination is performed while the patient is awake. However, in the past two decades, drug-induced sleep endoscopy (DISE) has been used as a method of tridimensional evaluation of the upper airway during pharmacologically induced sleep. This study aimed to systematically review the evidence regarding the usefulness of DISE compared with that of traditional awake examination for surgical decision making in patients with obstructive sleep apnea (OSA). DATA SOURCES: Scopus, PubMed, and Cochrane Library databases were searched. REVIEW METHODS: Only studies with a primary objective of evaluating the usefulness of DISE for surgical decision making in patients with OSA were selected. The included studies directly compared awake examination data with DISE outcome data in terms of possible influences on surgical decision making and operation success. RESULTS: A total of eight studies with 535 patients were included in this review. Overall, the surgical treatment changed after DISE in 50.24% (standard deviation 8.4) cases. These changes were more frequently associated with structures contributing to hypopharyngeal or laryngeal obstruction. However, these differences do not automatically indicate a higher success rate. CONCLUSION: This review emphasized the direct impact of DISE compared with that of awake examination on surgical decision making in OSA patients. However, it is also clear that the available published studies lack evidence on the association between this impact and surgical outcomes. Laryngoscope, 126:768-774, 2016.
Authors: Kenny Peter Pang; Guillermo Plaza; Peter M Baptista J; Carlos O'Connor Reina; Yiong Huak Chan; Kathleen A Pang; Edward B Pang; Cybil Mei Zhi Wang; Brian Rotenberg Journal: Eur Arch Otorhinolaryngol Date: 2018-05-25 Impact factor: 2.503
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