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Updated: May 29, 2026
07:54
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Hypopharyngeal Surgery in Obstructive Sleep Apnea: A Differential Pattern‑Based Surgical Decision
Sherif M Askar1, Nasser N N Mohamed1, Magdy B Ali1
1Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine Zagazig University Zagazig Egypt.
Summary
This study shows that a pattern-based surgical approach for obstructive sleep apnea (OSA) with hypopharyngeal collapse (HC) yields positive outcomes. The tailored surgical methods improved patient data significantly with no major complications.
Area of Science:
- Otolaryngology
- Sleep Medicine
- Surgical Innovation
Background:
- Obstructive sleep apnea (OSA) in patients with hypopharyngeal collapse (HC) presents unique surgical challenges.
- Preoperative endoscopic examination, including positional awake endoscopy and DISE (drug-induced sleep endoscopy), is crucial for identifying collapse patterns.
Purpose of the Study:
- To evaluate the outcomes of surgical interventions for OSA patients with HC.
- To assess a pattern-based surgical protocol guided by preoperative endoscopic findings.
Main Methods:
- Adult OSA patients with an apnea-hypopnea index (AHI) > 15 were included.
- Upper airway mapping via positional awake endoscopy and DISE identified collapse patterns (anteroposterior, transverse, concentric).
- Specific surgical techniques were applied based on the identified collapse pattern: tongue base coblation reduction for anteroposterior, hyoidthyroidpexy for transverse, and both for concentric collapse.
Main Results:
- No early or late major complications were reported.
- Significant improvements in all objective and subjective data were observed within treatment groups (p=0.0001).
- Postoperative AHI showed significant differences between surgical groups, indicating varying efficacy based on collapse pattern and intervention.
Conclusions:
- A pattern-based surgical protocol for OSA with HC demonstrates favorable subjective and objective outcomes.
- This approach offers a potential framework for selecting appropriate surgical decisions and tailoring individual maneuvers.
- Further research is needed to determine the optimal surgical plan for OSA patients with HC.
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