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Updated: Oct 29, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Concentric vs Anteroposterior-Laterolateral Collapse of the Soft Palate in Patients With Obstructive Sleep Apnea
Eli Van de Perck1,2, Clemens Heiser3, Olivier M Vanderveken1,2,4
1Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Abstract:
The presence of complete concentric collapse of the soft palate (CCCp) during drug-induced sleep endoscopy (DISE) has important therapeutic consequences. However, CCCp may present in various, sometimes doubtful, ways due to the complex anatomy of the upper airway. Herein, we aimed to characterize these doubtful variants by reviewing the DISE recordings of patients with obstructive sleep apnea (n = 332). We observed in some individuals that the soft palate collapsed in an anteroposterior-laterolateral (AP-LL) way, producing a polygonal shape that was distinct from CCCp. Patients with this collapse pattern (n = 29) had a smaller neck circumference and less severe obstructive sleep apnea than patients with CCCp (n = 68). The majority of patients with AP-LL collapse (n = 19) were originally diagnosed with CCCp. Based on these findings, AP-LL collapse of the soft palate might represent a distinct DISE phenotype that is easily confounded with CCCp.
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