Endoscopic Examination of Obstructive Sleep Apnea Syndrome Patients During Drug-induced Sleep

Iwanaga, Koichi; Hasegawa, Kiyokazu; Shibata, Nobuhiro; Kawakatsu, Kenji; Akita, Yasutaka; Suzuki, Kenji; Yagisawa, Mikio; Nishimura, Tadao

doi:10.1080/0365523031000055

Cited by 88 publications

(58 citation statements)

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“…Iwanaga et al reported a tendency toward increased incidence of BMI >30 in patients with a circumferential palatal or palatal obstruction in combination with base of tongue collapse. 29 A complete collapse and tongue base collapse were also more pronounced in patients with a higher AHI. Similar conclusions were made by Steinhart et al, who reported that patients with high AHI values exhibited a more pronounced collapsibility at the base of tongue.…”

Section: Discussionmentioning

confidence: 95%

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

2011

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Section: Discussionmentioning

confidence: 95%

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

2011

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“…Studies show that subjects with palatal obstruction alone (vs. multilevel obstruction) on DISE had better outcomes after palate surgery [9,10], and the resolution of airway obstruction with manual mandibular advancement under sedation is associated with improved outcomes with treatment using mandibular repositioning appliances [11,12]. However, in spite of over two decades of experience, important clinically relevant questions remain unanswered.…”

Section: Introductionmentioning

confidence: 99%

Drug-induced sleep endoscopy: the VOTE classification

Kezirian

Hohenhorst²,

Vries

2011

Eur Arch Otorhinolaryngol

566

433

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The surgical evaluation of obstructive sleep apnea is designed to characterize the pattern of upper airway obstruction in order to develop an effective treatment plan for an individual patient. Drug-induced sleep endoscopy (DISE) is one evaluation technique that involves assessment of individuals under pharmacologic sedation designed to simulate natural sleep, utilizing fiberoptic endoscopy to examine the upper airway. Developed in multiple centers throughout Europe, DISE was first described in 1991 and is performed widely around the world. Although multiple studies support a potential role for DISE in evaluation for treatment with surgery and mandibular repositioning appliances, important clinical questions remain unanswered. A major limitation in advancing our understanding of drug-induced sleep endoscopy has been the multiplicity and, in many cases, the complexity of classification systems that prevent the comparison of results across the studies and centers. We present the VOTE classification, a method for characterizing DISE findings that focuses on its core feature, the specific structures that contribute to obstruction.

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“…Furthermore he reports a 100% success rate in patients with collapse due to tonsillar cause. Iwanaga et al [33] has also reported a difference between the postoperative results of patients according to the morphology of the collapse, reporting 74% for the anteroposterior type and 53% for the circular.…”

Section: Discussionmentioning

confidence: 99%

Morphological Characteristics of Osa Patients Using Drug Induced Sleep Endoscopy

Tabbakh¹

2017

JOENTR

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To evaluate the reliability of drug induced sleep endoscopy (DISE) in identifying levels and degrees of severity of obstruction in sleep disordered breathing (SDB) patients. Patients with obstructive sleep apnea syndrome (OSAS) and habitual snoring diagnosed by polysomnography assessed by history and Epworth Sleepiness Scale (ESS), modified Malampatti index, Friedman staging system, Assessment of the Body mass index (BMI), neck circumference (NC), Müller maneuver (MM) and DISE using the NOHL (nose, oropharynx, hypopharynx and larynx) classification system. Our results revealed 66 patients, 34 males and 32 females with ages ranging from 23 to 58 years. BMI showed that 86.4 % of cases were obese with mean BMI (35.1 ± 5.6) ranging from (24 -50 kg/m 2 ). NC showed large NC (> 37cm) in 100 % of females while it was large (> 43 cm) in only 29.4 % of males. The mean apnea/hypopnea index was 10.7 ± (11.8/h). Obstruction at oropharyngeal level was 82% of the patients with grades ranging from 50 to 100%followed by obstruction at the level of hypopharynx in 68%. Only 13.6% showed supraglottic obstruction due to flappy epiglottis. Almost all patients showed multilevel obstruction with different grades. We found no correlation between the results of DISE, MM and classic ENT evaluation techniques. DISE treatment recommendations was different in 82% of patients at the oropharyngeal level and in 39% at the hypopharyngeal level than those of MM, but was nearly the same regarding supraglottic obstruction.Conclusion: DISE is a reliable tool of upper airway collapse assessment leading to better treatment recommendations for SDB patients.

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Endoscopic Examination of Obstructive Sleep Apnea Syndrome Patients During Drug-induced Sleep

Cited by 88 publications

References 0 publications

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

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

Drug-induced sleep endoscopy: the VOTE classification

Morphological Characteristics of Osa Patients Using Drug Induced Sleep Endoscopy

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