title: Drug-Induced Sleep Endoscopy Changes the Treatment Concept in Patients with Obstructive Sleep Apnoea.
abstract: The present study evaluated whether drug-induced sleep endoscopy (DISE) helps identify the site of obstruction in patients with obstructive sleep apnoea (OSA). A total of 51 consecutive patients with polysomnography-confirmed OSA were enrolled in this prospective study. The presumed site of obstruction was determined according to history, otorhinolaryngologic examination, and polysomnography and a therapeutic plan designed before DISE. In 11 patients with severe OSA and/or previously failed continuous positive airway pressure (CPAP) treatment, DISE with simultaneous CPAP was performed. Multilevel collapse was noted in 49 patients (96.1%). The most frequent multilevel collapse was palatal, oropharyngeal, and tongue base collapse (n= 17, 33.3%), followed by palatal and oropharyngeal collapse (n= 12, 23.5%). Pathology of the larynx (epiglottis) was observed in 16 patients (31.4%). The laryngeal obstruction as a reason for intolerance of CPAP was observed in 3/11 (27.3%) patients. After DISE, the surgical plan was changed in 31 patients (60.8%). The results indicate that DISE helps identify the site of obstruction in the upper airways in patients with OSA more accurately and that the larynx plays an important role in OSA.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, Ostrava, Czech Republic.
authors.forename: Jaroslava
authors.identifier: 0000-0002-2770-6447
authors.initials: J
authors.lastname: Hybášková
authors.affiliation: Department of Anesthesiology, Resuscitation and Intensive Medicine, University Hospital Ostrava, Ostrava, Czech Republic.
authors.forename: Ondřej
authors.initials: O
authors.lastname: Jor
authors.affiliation: Department of Pediatric Neurology, University Hospital Ostrava, Ostrava, Czech Republic.
authors.forename: Vilém
authors.initials: V
authors.lastname: Novák
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, Ostrava, Czech Republic; Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
authors.forename: Karol
authors.identifier: 0000-0003-1349-9958
authors.initials: K
authors.lastname: Zeleník
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, Ostrava, Czech Republic; Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Matoušek
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, Ostrava, Czech Republic; Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
authors.forename: Pavel
authors.identifier: 0000-0001-6238-0756
authors.initials: P
authors.lastname: Komínek
mesh_terms: D000293:Adolescent; D000328:Adult; D000402:Airway Obstruction / Q000503:physiopathology; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local; D045422:Continuous Positive Airway Pressure; D004724:Endoscopy / Q000379:methods*; D004825:Epiglottis / Q000503:physiopathology; D005260:Female; D006801:Humans; D007830:Larynx / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000503:physiopathology; D010036:Otolaryngology; D017286:Polysomnography / Q000379:methods; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D014059:Tongue / Q000601:surgery; D055815:Young Adult
chemical_list: D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D015742:Propofol