Drug-induced sleep endoscopy

Kohn, Jocelyn; Gillespie, M. Boyd

doi:10.1016/j.otot.2015.03.004

Cited by 5 publications

(2 citation statements)

References 27 publications

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“…The four patients who underwent MRI scans also underwent assessment using drug‐induced sleep endoscopy (DISE), whereby a state of mimicked sleep was induced using sedation with an intravenous infusion of propofol in the operating room . Adequate depth of sedation was measured clinically by ensuring purposeful response to painful or repeated stimulation while maintaining spontaneous ventilation, as well as via bispectral index monitor.…”

Section: Methodsmentioning

confidence: 99%

“…The four patients who underwent MRI scans also underwent assessment using drug-induced sleep endoscopy (DISE), whereby a state of mimicked sleep was induced using sedation with an intravenous infusion of propofol in the operating room. 14,15 Adequate depth of sedation was measured clinically by ensuring purposeful response to painful or repeated stimulation while maintaining spontaneous ventilation, as well as via bispectral index monitor. Patients had their upper airway anatomy assessed using indirect visualization with a nasopharyngoscope, and the degree of airway collapse and site of maximal collapse were noted on this endoscopic examination using the VOTE protocol.…”

Section: Endoscopic Validationmentioning

confidence: 99%

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Constructing a patient‐specific computer model of the upper airway in sleep apnea patients

et al. 2017

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Objective: The use of computer simulation to develop a high-fidelity model has been proposed as a novel and costeffective alternative to help guide therapeutic intervention in sleep apnea surgery. We describe a computer model based on patient-specific anatomy of obstructive sleep apnea (OSA) subjects wherein the percentage and sites of upper airway collapse are compared to findings on drug-induced sleep endoscopy (DISE).Study Design: Basic science computer model generation.Methods: Three-dimensional finite element techniques were undertaken for model development in a pilot study of four OSA patients. Magnetic resonance imaging was used to capture patient anatomy and software employed to outline critical anatomical structures. A finite-element mesh was applied to the volume enclosed by each structure. Linear and hyperelastic soft-tissue properties for various subsites (tonsils, uvula, soft palate, and tongue base) were derived using an inverse finiteelement technique from surgical specimens. Each model underwent computer simulation to determine the degree of displacement on various structures within the upper airway, and these findings were compared to DISE exams performed on the four study patients.Results: Computer simulation predictions for percentage of airway collapse and site of maximal collapse show agreement with observed results seen on endoscopic visualization.Conclusion: Modeling the upper airway in OSA patients is feasible and holds promise in aiding patient-specific surgical treatment.

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Section: Methodsmentioning

confidence: 99%

Section: Endoscopic Validationmentioning

confidence: 99%

Constructing a patient‐specific computer model of the upper airway in sleep apnea patients

et al. 2017

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Robotic Tongue‐Base Resection Combined With Tongue‐Base Suspension for Obstructive Sleep Apnea

Turhan

Bostancı

2019

The Laryngoscope

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Objectives/HypothesisOur primary objective was to evaluate the feasibility, morbidity, and efficacy of transoral robotic surgery (TORS) tongue‐base resection (TBR) combined with tongue‐base suspension (TBS) for obstructive sleep apnea (OSA) with tongue‐base collapse. Our secondary objective included evaluation of factors influencing treatment success.Study DesignSingle‐arm, prospective, observational cohort study.MethodsPatients were eligible if they had moderate‐to‐severe OSA (apnea hypopnea index [AHI] > 15) or positional OSA, had a tongue‐base collapse and glossoptosis identified by drug‐induced sleep endoscopy (DISE), and failed continuous positive airway pressure. All patients underwent TORS‐TBR combined with TBS. Additionally, concomitant epiglottoplasty, uvulopalatopharyngoplasty, or expansion pharyngoplasty were performed based on DISE findings.ResultsIn total, 64 patients were enrolled in the trial. The mean age was 45.9 years, mean body mass index was 30.5 kg/m2, and mean AHI was 41.7 events/hour. The mean robotic surgical time, total volume of tongue‐base tissue removed, and the length of hospital stay were 21.4 minutes, 15.16 mL, and 6.5 days, respectively. Postoperatively, almost all polysomnographic metrics improved significantly (AHI = 41.72 vs. 18.82 events/hour, lowest oxygen saturation = 80.43% vs. 85.14%, Epworth Sleepiness Scale = 10.49 vs. 4.09). The procedure provided an overall success rate of 75%, with minor morbidity. All patients experienced varying degrees of temporary lingual edema postoperatively. Tracheotomy was not required for any patient. Although no independent predictor of treatment success was determined, patients with more severe disease tend to exhibit lower response to the treatment.ConclusionsTORS‐TBR combined with TBS is a feasible, safe, and efficient procedure for OSA with tongue‐base collapse.Level of Evidence4 Laryngoscope, 130:2285–2291, 2020

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Can be compared obstructive respiratory events during drug induced sleep endoscopy (DISE) and nocturnal polysomnography

Ghorbani

Naghan

Naeini

et al. 2020

Eur Arch Otorhinolaryngol

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Drug-induced sleep endoscopy

Cited by 5 publications

References 27 publications

Constructing a patient‐specific computer model of the upper airway in sleep apnea patients

Constructing a patient‐specific computer model of the upper airway in sleep apnea patients

Robotic Tongue‐Base Resection Combined With Tongue‐Base Suspension for Obstructive Sleep Apnea

Can be compared obstructive respiratory events during drug induced sleep endoscopy (DISE) and nocturnal polysomnography

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