Drug Induced Sleep Endoscopy in Obstructive Sleep Apnea

Area of Science:

• Otolaryngology
• Sleep Medicine
• Surgical Anatomy

Background:

• Accurate identification of upper airway obstruction is crucial for surgical treatment of Obstructive Sleep Apnea (OSA).
• Drug-Induced Sleep Endoscopy (DISE) is the preferred method for visualizing dynamic airway collapse in sedated OSA patients.

Purpose of the Study:

• To evaluate the safety and diagnostic utility of DISE in adult OSA patients.
• To investigate the relationship between patient characteristics, such as BMI, and patterns of upper airway collapse.

Main Methods:

• A prospective cross-sectional study involving adult OSA patients diagnosed via polysomnography.
• DISE performed by an otolaryngologist under propofol sedation in an operating room setting.
• Systematic recording and analysis of endoscopic findings, including obstruction level, severity, and multiplicity.

Main Results:

• Twenty OSA patients (mean age 38.9 years, mean BMI 26.57 kg/m²) were included.
• Severe OSA was present in 55% of participants.
• Multilevel airway collapse was observed in 65% of patients, particularly those with BMI > 30 (p<0.05).
• Increasing BMI correlated with a shift from uni-level to multilevel obstruction.
• No complications were reported with propofol or the endoscopy procedure.

Conclusions:

• DISE is a safe, straightforward, and informative procedure for OSA patients.
• A significant association exists between obesity and multilevel upper airway collapse in OSA.
• DISE aids in precise localization of airway collapse for surgical planning.