Drug-Induced Sedation Endoscopy (DISE) DATA FUSION system: clinical feasibility study

Abstract

Drug-induced sleep endoscopy (DISE) is a diagnostic technique for 3D dynamic anatomical visualisation of upper airway obstruction during sedated sleep. There is a lack of standardised procedure and objective measurement associated with information capture, information management, evaluation of DISE findings, treatment planning, and treatment outcomes. The objective of this study is to present clinical feasibility results using a DISE DATA FUSION system for capturing, merging, displaying and storing anatomical data from an endoscopic imaging system and cardiorespiratory data from an anaesthesiological monitoring system simultaneously in real-time during DISE. This prospective cohort study included 20 patients presenting with symptoms of sleep related breathing disorders undergoing drug-induced sedation endoscopy and had volunteered for DISE DATA FUSION system to be used during their DISE assessment. The DISE DATA FUSION system was used to capture, merge, display, and store anatomical changes from an endoscopic imaging system and cardiorespiratory changes from an anaesthesiological monitoring system simultaneously in real time during drug-induced sedation endoscopy assessment. In all 20 patients, anatomical obstructions at different levels of the pharyngeal lumen (soft palate, velum, tonsils, oropharynx lateral wall, base of tongue, and epiglottis) with a different obstruction configuration and severity were captured simultaneously in real time with its associated cardiorespiratory parameters. Furthermore, a composite video consisting of an anatomical image, blood oxygen level, pulse rate, blood pressure, and timestamp was created for every obstructive event. Our system provides a useful and better way of capturing, merging, visualising, and storing anatomical data/physiological data simultaneously during DISE in real time. Furthermore, it enhances the understanding of the impact of the anatomical severity due to the simultaneous display of the cardiovascular parameters at that specific time of anatomical obstruction for optimising surgical decision based on DISE.Electronic supplementary materialThe online version of this article (doi:10.1007/s00405-017-4765-7) contains supplementary material, which is available to authorized users.

Quantitative Measurement of Throat and Larynx After Endotracheal Intubation for Palatoplasty

“…In most previous studies, the degree of upper airway obstruction of patients with obstructive sleep apnea was evaluated with polysomnography, multiple sleep latency tests, Muller maneuver, etc. drug-induced sleep endoscopy is widely used now, due to its superiority to dynamic observation of volumetric changes in the upper airway ( 17 ). However, drug-induced sleep endoscopy is more invasive and depends on the clinicians' subjective judgment.…”

<p>Quantitative Morphometric Measurements of the Oropharynx in Obstructive Sleep Apnea Syndrome Using a Laser Depth Measurement Module</p>

“…Characteristics and the Anthropometric Measurements of the OSAS Group The retropalatal depth was significantly decreased in both female and male patients with OSAS (9.07±0.87 and 8.12±1.44 mm, respectively) as compared to those without OSAS (14.25±1.36 and 11.76±1.41 mm, respectively) (all p values <0.05). Men with OSAS had significantly smaller CSAOI than men without OSAS (213.49±18.44 vs 269.22±30.89 mm2 , p values <0.05). A similar trend was observed in females (192.06±20.72 vs 176.36±28.27 mm 2 ) but without statistical significance.…”

“…1 Techniques that are used to characterize the obstruction in OSAS, such as physical examination with Mallampati score or Friedman staging, fiber-optic nasal endoscopic evaluation with Muller maneuver, and drug-induced sleep endoscopy (DISE), provide only subjective, qualitative, or semi-quantitative data, with considerable inter-rater reliability. 2 Cephalometric roentgenogram is cost-effective, but its use is limited due to the inherent ambiguity of locating landmarks and surfaces on the x-ray image. 3 Computed tomography (CT) scanning and magnetic resonance imaging (MRI) provide better information in assessing the objective absolute value, but they are not widely available and are associated with high costs.…”

The clinical application progress and potential of drug-induced sleep endoscopy in obstructive sleep apnea

“…[ 19 ] proposed a polygraph to capture, fuse, display and store images of UA obstructions and cardiorespiratory parameters simultaneously during DISE. In 2018, Dijemeni and Kotech also designed a system that could simultaneously display UA dynamic video and cardiovascular parameters, called DISE Data Fusion [ 35 ].…”

“… AP: anterior-posterior, anterior structures moving posteriorly against the posterior pharyngeal wall; L or T: lateral or transversal, lateral pharyngeal structures moving towards to the midline of the lumen; C: concentric, a combination of anterior–posterior plus lateral wall movement. Details of VOTE, NOHL and u-DISE classifications could be found in the references [ 12 , 35 , 37 ]. a Retropalatal space.…”