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Updated: Nov 10, 2025
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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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Functional Upper Airway Space Endoscopy: A Prognostic Indicator in Obstructive Sleep Apnea Treatment with Mandibular
Giulio Gasparini1, Gianmarco Saponaro1, Mattia Todaro1
1Maxillofacial Surgery Unit, Faculty of Medicine, University Hospital 'A. Gemelli', Catholic University of the Sacred Heart, IRCCS, 00168 Rome, Italy.
Summary
Awake upper airway endoscopy can predict the effectiveness of mandibular advancement devices (MAD) for obstructive sleep apnea (OSA). Patients showing soft tissue expansion or stretch during the exam experienced significant apnea-hypopnea index (AHI) reduction with MAD therapy.
Area of Science:
- Sleep Medicine
- Otolaryngology
- Medical Devices
Background:
- Obstructive sleep apnea (OSA) is a common sleep disorder.
- Mandibular advancement devices (MAD) are a recognized treatment for OSA.
- Predicting MAD therapy outcomes is crucial for patient management.
Purpose of the Study:
- To assess the predictive capability of awake upper airway (UA) functional endoscopy for MAD treatment success in OSA patients.
- To determine if UA soft tissue response during endoscopy correlates with apnea-hypopnea index (AHI) reduction.
Main Methods:
- An observational prospective study involving 30 adult OSA patients.
- Pre-treatment awake UA functional endoscopy was performed, with patients maximally advancing their mandible.
- Patients were categorized into three groups based on soft tissue response: expansion (A), stretch (B), and unchanged (C).
Main Results:
- Significant AHI reduction was observed in patients with soft tissue expansion (Group A) and stretch (Group B).
- A minor AHI reduction was noted in patients with unchanged soft tissue (Group C).
Conclusions:
- Awake UA functional endoscopy is a valuable prognostic tool for identifying MAD responders and non-responders.
- The study suggests the potential to predict post-treatment AHI ranges based on endoscopic findings.
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