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Related Experiment Video

Updated: Jul 10, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
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Potential Treatments for Epiglottic Collapse in Obstructive Sleep Apnea: How Modified Drug-Induced Sleep Endoscopy

Hua-Wei Shih1, Yu-Lin Chen2, Hung-Che Lin3,4

  • 1Department of Otolaryngology, Shin Kong Wu-Ho-Su memorial Hospital, Taipei City, Taiwan.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|November 24, 2023
PubMed
Summary
This summary is machine-generated.

Head rotation combined with mouth closure effectively treats anteroposterior epiglottic collapse in obstructive sleep apnea patients. Oral appliances with head rotation also improved lateral epiglottic collapse, offering new therapeutic options.

Keywords:
anteroposterior epiglottic collapsedrug-induced sleep endoscopyhead rotationiNAPlateral epiglottic collapsemouth closureobstructive sleep apneaoral appliancetarget-controlled infusion

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Area of Science:

  • Sleep Medicine
  • Otolaryngology
  • Respiratory Medicine

Background:

  • Obstructive sleep apnea (OSA) is a common disorder characterized by repeated episodes of upper airway collapse during sleep.
  • Epiglottic collapse (EC) is a significant contributor to the failure of standard OSA treatments like continuous positive airway pressure (CPAP) and uvulopalatopharyngoplasty.
  • Identifying effective treatments for EC is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the efficacy of various interventions in managing epiglottic collapse (EC) in patients with obstructive sleep apnea (OSA).
  • To evaluate treatments for anteroposterior epiglottic collapse (apEC) and lateral epiglottic collapse (latEC) using drug-induced sleep endoscopy with target-controlled infusion (TCI-DISE).

Main Methods:

  • Retrospective cohort study conducted at a tertiary center.
  • Screened 352 OSA patients undergoing TCI-DISE (2016-2022); 54 patients with EC were analyzed.
  • Assessed EC severity with interventions including head rotation, mouth closure, oral appliances (OA), and intermittent negative airway pressure (iNAP) during TCI-DISE.

Main Results:

  • Head rotation and mouth closure significantly reduced apEC severity in 60.0% and 53.6% of patients, respectively.
  • Combined interventions showed higher efficacy: head rotation with mouth closure improved apEC in 77.8% of patients.
  • Oral appliances with head rotation were effective for latEC, improving severity in 61.5% of patients.

Conclusions:

  • Head rotation with mouth closure is the most effective treatment for apEC identified via TCI-DISE.
  • Patients with latEC tend to have higher BMI and apnea-hypopnea index compared to those with apEC.
  • Oral appliance use combined with head rotation shows promise for treating latEC in OSA patients.