A trial of drug‐induced sleep endoscopy in the surgical management of sleep‐disordered breathing

Abstract

Drug-induced sleep endoscopy provides more clinical information to assess airway function and collapse than awake endoscopy alone and assists in the surgical planning. Additional investigation is needed to standardize drug-induced sleep endoscopy techniques, training, and interpretation.

Drug-induced sleep endoscopy in the identification of obstruction sites in patients with obstructive sleep apnea: a systematic review

“…Test---retest reliability was good (K = 0.61). 18 The inter-rater reliability was also observed by Kezirian et al in a prospective study of 108 patients, in which all subjects exhibited evidence of palatal obstruction and most also demonstrated hypopharyngeal obstruction. Both reviewers determined that most individuals had palate and hypopharynx obstruction.…”

The Utility of Sleep Endoscopy in Adults with Obstructive Sleep Apnea: A Review of the Literature

“…Slow stepwise induction is required to avoid oversedation. Recently, bispectral index monitoring (BIS) during DISE has been introduced to determine the level of sedation required for assessment of snoring and/or obstruction [28,32]. Once the patient has reached a satisfactory level of sedation, a flexible endoscope is introduced into the nasal cavity.…”

“…In Friedman I and II tongue positions [39] the greatest difference was found (DISE 88.9 %, OPDA 16.7 %). Gillespie et al [32] prospectively studied a group of 38 patients and found a change in surgical plan after DISE in 23 (62 %) patients compared to awake endoscopy. A high ASA (C3) score and propofol or midazolam allergies (albeit rare) are considered contraindications.…”

Novel Surgical Approaches for the Treatment of Obstructive Sleep Apnea

“…[7][8][9] Evidence is emerging that certain DISE findings are related to treatment outcome and that DISE is a valuable selection tool in treatment decision-making. [10][11][12][13][14][15] Approximately 100 articles have been published on DISE just in the last 5 years. The recently published European position paper provides a comprehensive review and starting point for the reader interested in more in-depth analysis of the data and controversies surrounding DISE.…”