European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 5, pp 1311–1319 | Cite as

Drug-induced sleep endoscopy changes snoring management plan very significantly compared to standard clinical evaluation

  • Karen Pilaete
  • Joris De Medts
  • Kathelijne Godelieve Delsupehe
Miscellaneous

Abstract

Drug-induced sleep endoscopy (DISE) is a new tool in the work-up of patients with sleep-disordered breathing (SDB). We assessed the impact of DISE on the treatment plan of snoring patients. This is a single institution prospective longitudinal clinical trial. The setting is a private teaching hospital. A consecutive series of 100 snoring patients prospectively underwent a standardised questionnaire, clinical examination, rhinomanometry, allergy skin prick testing, DISE and polysomnography. Management plan before and after DISE evaluation was compared. In 61 patients (excluding 16 patients sent for continuous positive airway pressure, three patients refused sleep endoscopy and 20 were lost to follow-up), we compared the treatment plans. DISE showed single level airway collapse in 13 and multilevel collapse in 48 patients. The site of flutter did not add additional information as compared to the pattern and the location of the collapse. After DISE, the initial management plan changed in 41 % of patients irrespective of the type of initial management plan. The only somewhat accurate initial treatment plan was uvulopalatopharyngoplasty (unchanged in 11/13 patients). Excluding moderate to severe obstructive sleep apnea patients DISE is an indispensable tool in treatment decision in all SDB patients. We suggest to simplify the protocol for DISE reporting.

Keywords

Drug-induced sleep endoscopy DISE Sleep endoscopy Snoring treatment Sleep-disordered breathing 

Abbreviations

AHI

Apnea Hypopnea Index

BIS

Bispectral index monitoring

CPAP

Continuous positive airway pressure therapy

DISE

Drug-induced sleep endoscopy

MAD

Mandibular advancement device

OSA

Obstructive sleep apnea

PSG

Polysomnography

RF

Radiofrequency

SDB

Sleep-disordered breathing

TCI

Target controlled infusion

UPPP

Uvulopalatopharyngoplasty

Notes

Acknowledgments

The authors want to thank the whole anaesthesia team of our institution for providing support in titrated sedation. Stephanie Terryn MD for her assistance with collecting data and Jeroen Meulemans MD and Stephanie Terryn MD for the interpretation of the DISE reporting and all the members of our multidisciplinary snoring team in our institution (Bernard Bouckaert MD, Marc Vanden Bulcke MDS DDS PhD, Sabine Van Pelt MD, Philippe Vuylsteke MD).

Conflict of interest

All authors declare that they have no conflicts of interest with regard to this manuscript.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Karen Pilaete
    • 1
  • Joris De Medts
    • 2
  • Kathelijne Godelieve Delsupehe
    • 2
  1. 1.ENT DepartmentUniversity Hospitals of LeuvenLeuvenBelgium
  2. 2.ENT DepartmentH.-Hart Ziekenhuis Roeselare-MenenRoeselareBelgium

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