Current Techniques and Role of Drug-Induced Sleep Endoscopy for Obstructive Sleep Apnea
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Purpose of Review
Drug-induced sleep endoscopy (DISE) was developed for dynamic evaluation of the airway collapse under simulated sleep conditions. DISE has been extensively studied in the last 25 years to standardize the procedures and classification as well as its role in non-surgical and surgical management. The goal of this study is to determine current techniques and recommendations regarding DISE.
Current research suggests that standardization with target-controlled infusion and bispectral analysis may be safer and more reproducible. The velum, oropharyngeal, tongue base, epiglottis classification remains the most commonly used to describe the obstruction. While DISE changes surgical management in 50% of patients, there are few studies to evaluate differences in surgical outcomes with and without DISE. Emerging evidence suggests complete collapse of the velum and hypopharyngeal obstruction are associated with poor surgical outcomes.
Going forward, more information is required to determine how well DISE mimics natural sleep and its role in decision-making for patients seeking alternatives to continuous positive airway pressure.
KeywordsDrug-induced sleep endoscopy Obstructive sleep apnea Bispectral analysis Müller’s maneuver
Body mass index
Complete concentric collapse
Drug-induced sleep endoscopy
Oxygen desaturation index
Obstructive sleep apnea
Velum, oropharyngeal, tongue base, epiglottis
Compliance with Ethical Standards
Conflict of Interest
Melissa S. Oh and Raj C. Dedhia each declare no potential conflicts of interest.
Human and Animal Rights and Informed Consent
All reported studies with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).
Papers of particular interest, published recently have been highlighted as: • Of importance. •• Of major importance
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