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Updated: Nov 21, 2025
07:54
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
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Drug-Induced Sleep Endoscopy and Hypoglossal Nerve Stimulation Outcomes: A Multicenter Cohort Study
Phillip Huyett1, David T Kent2, Mark A D'Agostino3,4
1Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.
The Laryngoscope
|January 14, 2021
Summary
Preoperative drug-induced sleep endoscopy (DISE) findings predict hypoglossal nerve stimulation (HNS) success for obstructive sleep apnea (OSA). Tongue obstruction indicates better outcomes, while lateral wall issues suggest lower response rates.
Area of Science:
- Sleep Medicine
- Otolaryngology
- Surgical Innovation
Background:
- Obstructive sleep apnea (OSA) affects millions globally.
- Hypoglossal nerve stimulation (HNS) offers a treatment option for moderate to severe OSA.
- Predicting HNS success is crucial for patient selection.
Purpose of the Study:
- To assess the association between preoperative drug-induced sleep endoscopy (DISE) findings and HNS treatment outcomes in OSA patients.
- To determine if specific airway obstruction patterns identified during DISE correlate with HNS efficacy.
Main Methods:
- Retrospective, multicenter cohort study of 343 adult OSA patients treated with HNS.
- Preoperative DISE videos were analyzed by blinded reviewers using the VOTE Classification.
- Treatment response was defined by a significant reduction in apnea-hypopnea index (AHI) on post-treatment polysomnography.
Main Results:
- A 72.6% treatment response rate was observed in the cohort.
- Complete tongue-related obstruction was associated with increased odds of treatment response (78% vs. 68%).
- Complete oropharyngeal lateral wall obstruction was linked to lower odds of surgical response (58% vs. 74%).
Conclusions:
- DISE findings, particularly tongue contribution, are associated with better HNS outcomes for OSA.
- Lateral wall obstruction identified during DISE may predict poorer response to HNS.
- DISE is valuable for HNS candidate selection beyond just identifying velum collapse.
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