Drug-induced sedation endoscopy (DISE) classification systems: a systematic review and meta-analysis

Area of Science:

• Otolaryngology
• Sleep Medicine
• Surgical Innovation

Background:

• Drug-induced sedation endoscopy (DISE) is utilized for evaluating upper airway obstruction in obstructive sleep apnea (OSA).
• DISE findings inform surgical treatment decisions and predict outcomes for OSA management.
• The current landscape of DISE classification systems is fragmented and lacks universal standardization.

Purpose of the Study:

• To determine if a universally accepted DISE grading and classification system exists for analyzing findings.
• To ascertain if a standardized DISE framework exists for surgical treatment planning in OSA.
• To identify if a DISE classification system reliably predicts surgical treatment success for OSA.

Main Methods:

• A systematic review was conducted to identify and analyze new and modified DISE classification systems.
• The review focused on the concepts, advantages, and disadvantages of various DISE classification approaches.
• Study selection included fourteen new and three modified DISE classification systems.

Main Results:

• Fourteen new and three significantly modified DISE classification systems were identified in the literature.
• No randomized controlled trials were found to support the existing DISE classification systems.
• The identified systems vary in their approach to classifying DISE findings.

Conclusions:

• DISE provides an objective visualization of upper airway obstruction.
• The proliferation of DISE classification systems results in subjective assessments and divergent surgical planning.
• A critical need exists for a universally accepted, objective DISE assessment to standardize treatment and improve outcomes.