Test‐retest reliability of drug‐induced sleep endoscopy

Abstract

Objective To determine the test-retest reliability of drug-induced sleep endoscopy (DISE). Methods Prospective cohort study. Patients with OSA underwent two separate DISE examinations. The following outcomes were measured: a global assessment of obstruction at the palate and/or hypopharynx; the degree of obstruction at the palate and hypopharynx; and contribution of individual structures (palate, tonsils, tongue, epiglottis, and lateral pharyngeal walls) to obstruction. Results 32 patients underwent two separate DISE examinations. The apnea-hypopnea index was 40.7±21.1, and the lowest oxygen saturation was 79.8±17.4%. Point estimates for the intraclass correlation coefficient analogs related to palatal obstruction ranged from 0.41-0.89; related to the hypopharyngeal airway, the point estimates ranged from 0.57-0.84. Conclusion The test-retest reliability of DISE appears good, especially in the evaluation of the hypopharyngeal airway. Larger studies can generate more-precise confidence interval estimates and test the generalizability of these findings.

Retrospective-comparative study of patients with obstructive sleep apneas and hypopneas in awake endoscopy and drug induced sleep endoscopy

“…Clinically and statistically significant differences were observed in complete and partial concentric collapses, especially at the level of the velum, and partial collapse at the level of the oropharynx, tongue, and epiglottis. In previous studies, Capasso et al [18] and Yoon et al [10] observed important findings in terms of modified anatomic structures in velum, tongue, and epiglottis, but not such significant changes in the oropharynx, which is consistent with our own findings.…”

“…OSA evaluation requires extensive physical examination, imaging, and procedures such as awake endoscopy and DISE [10]. According to American and European literature, DISE is mainly indicated for: 1) moderate and severe OSA patients without morbid obesity who cannot tolerate CPAP as a diagnostic test before indication for surgery or mandibular advancement device; 2) patients with mild OSA or simple snoring with an indication for surgery or mandibular advancement device; and 3) patients with OSA who do not respond to surgery [11].…”

Evaluation of Drug-Induced Sleep Endoscopy as a Patient Selection Tool for Implanted Upper Airway Stimulation for Obstructive Sleep Apnea

“…22,23,34,35 Recent studies that address the test-retest and the intra-and interobserver variability in DISE scoring indicate that the reliability of both are moderate to fair, and that inter-observer agreement is higher in ENT surgeons who are experienced with DISE. [36][37][38][39] The limitations of this study also include the fact that DISE was performed only in the supine position, whereas upper airway collapse patterns should ideally be assessed in both the supine and non-supine position 40 . It is well known that the probability of a multilevel collapse is significantly associated with the severity of OSA, as higher AHI values are correlated with a higher percentage of multilevel collapse.…”

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

“…Rodriguez-Bruno et al [45] prospectively studied 32 patients undergoing 2 separate DISE examinations. Both examinations were evaluated by one unblinded surgeon and one blinded surgeon (with only knowledge of whether or not the patient had undergone prior tonsillectomy).…”