Drug-induced sleep endoscopy versus Müller maneuver in patients with retropalatal obstruction

This study aimed to compare application of the Müller maneuver (MM) and application of drug-induced sleep endoscopy (DISE) prior to surgery, in addition to MM, to further ascertain the location of an obstruction in the upper airway and whether the location would change the surgical treatment plan in patients with retropalatal obstruction.

Prospective, clinical trial at a tertiary referral hospital.

This study included 39 obstructive sleep apnea patients who were recommended for surgical treatment. Patients were randomly divided into two groups: The first group (DISE plus MM) underwent a DISE (19 patients), in addition to the planned procedure according to MM. Meanwhile, the second group (MM only) underwent surgery based only on their MM evaluation (20 patients). Patients with retrolingual-localized obstructions were excluded, whereas patients with ≥ third-degree obstructions at the retropalatal level, according to DISE and/or MM, were included in the study.

There was a significant improvement between pre- and postoperative polysomnography findings in both groups. However, the postoperative improvements between the groups were not statistically different. Because there was a significant change in the planned surgical procedures in the first group, there were significantly more combined surgeries followed by the DISE procedure.

Although the DISE resulted in more changes in the surgical treatment plan and higher rate of combined treatment compared to MM, we determined that this difference did not result in a significant difference in treatment success.

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