Transoral Drug-Induced Sleep Endoscopy: A Useful Complementary Tool in Sleep Surgery

Introduction  Drug-induced sleep endoscopy (DISE) is performed widely, and several studies have demonstrated its validity as it provides clinical information not available by routine clinical inspection alone. Objective  This study aims to evaluate the role of transoral drug-induced sleep endoscopy (DISE) in the evaluation of tongue-palate (TP) interaction and its impact on surgical outcomes. Methods  A total of 42 patients with known obstructive sleep apnea syndrome (OSAS) were classified into two groups according to TP interaction (the absence of space between tongue and palate with the visual impression that the tongue is pushing the soft palate) into +ve and -ve TP interaction. Snoring according to the visual analogue scale (VAS), the Epworth Sleepiness Scale (ESS), and sleep study data were recorded before and after the pharyngoplasty operation. Results  There was a statistically significant difference between studied groups postoperative regarding minimal oxygen saturation, snoring index, apnea-hypopnea index (AHI), the ESS, and visual analogue scale of snoring ( p  = 0.003*, p  < 0.001*, p  < 0.001*, p  = 0.004*, and p  = 0.003*, respectively). It displayed a marked higher average improvement among cases with -ve than in those with +ve TP interaction in terms of snoring index, AHI, and ESS. Conclusion  The Transoral DISE Has A Valuable Role In Evaluating And Assessing TP Interaction And Its Importance On Surgical Outcomes. Cases With Positive TP Interaction Show Poor Response To Isolated Palatopharyngeal Expansion And Need Further Analysis To Create A Better Treatment Plan And Improve Outcomes.