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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
Epiglottis Collapse in Individuals With Obstructive Sleep Apnea
Dan Chen1, Li Zhou1, Qi-Ying Zeng2
1Department of Otorhinolaryngology Hospital of Chengdu University of Traditional Chinese Medicine Chengdu China.
Summary
Epiglottic collapse is a key cause of obstructive sleep apnea (OSA) often missed by traditional methods. Drug-induced sleep endoscopy (DISE) and new tools improve diagnosis, with surgery offering an alternative for CPAP-intolerant patients.
Area of Science:
- Sleep Medicine
- Otolaryngology
- Respiratory Medicine
Background:
- Obstructive sleep apnea (OSA) involves repeated upper airway collapse during sleep.
- The epiglottis is an under-recognized site of obstruction in OSA.
- This review focuses on epiglottic collapse in adult OSA patients.
Purpose of the Study:
- To review current knowledge on the epidemiology, pathophysiology, diagnosis, and treatment of epiglottic collapse in adults with OSA.
- To highlight the significance of the epiglottis in OSA pathophysiology.
- To discuss diagnostic and therapeutic advancements.
Main Methods:
- Comprehensive literature search of PubMed, Embase, Web of Science, and Cochrane.
- Detailed review of publications on study design, sample size, assessment methods, treatments, and outcomes.
- Focus on epiglottic collapse in obstructive sleep apnea.
Main Results:
- Prevalence of epiglottic collapse in OSA varies widely (11.5%-73.5%) due to inconsistent diagnostic criteria.
- Drug-induced sleep endoscopy (DISE) is the gold standard, showing higher incidence than traditional methods.
- Emerging AI analytics, noninvasive aerodynamic assessments, and surgical interventions show diagnostic and therapeutic promise.
Conclusions:
- Epiglottic collapse is a critical, under-recognized component of OSA.
- Accurate diagnosis using DISE and innovative tools is crucial for optimal management.
- Standardized criteria and protocols are needed, with surgery as a promising option for CPAP-resistant cases.
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