title: Preoperative Drug Induced Sleep Endoscopy Improves the Surgical Approach to Treatment of Obstructive Sleep Apnea.
abstract: OBJECTIVE
  Drug induced sleep endoscopy (DISE) allows for preoperative evaluation of the specific site and character of upper airway obstruction in obstructive sleep apnea (OSA). We aim to assess the impact DISE has on customizing the surgical plan and evaluate its role in surgical success.
  
  
  METHODS
  We retrospectively reviewed patients undergoing surgery for OSA. We compared those patients undergoing preoperative DISE to those that did not to assess procedures performed and surgical outcomes.
  
  
  RESULTS
  We found 87 patients undergoing surgery for OSA who had postoperative polysomnogram results. Of the group undergoing preoperative DISE, 8% had multilevel surgery. This compared to 59.5% in those not undergoing DISE ( p = .0004). The success rate of patients who had preoperative DISE was 86% compared to 51.4% in those who did not have preoperative DISE ( p < .001). We found no difference in age, gender, preoperative apnea-hypopnea index (AHI), oxygen nadir, Epworth sleepiness scale score (ESS), body mass index (BMI) and postoperative oxygen nadir, ESS, or BMI in the DISE and no DISE cohorts.
  
  
  CONCLUSIONS
  The addition of DISE to our preoperative workup has contributed to a decreased rate of multilevel surgery and increased rate of surgical success through identification of the individual patient's OSA architecture and customization of the surgical plan.
authors.affiliation: 1 Thomas Jefferson University Department of Otolaryngology-Head & Neck Surgery, Philadelphia, Pennsylvania, USA.
authors.forename: Colin
authors.initials: C
authors.lastname: Huntley
authors.affiliation: 2 Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: David
authors.initials: D
authors.lastname: Chou
authors.affiliation: 3 Jefferson Sleep Disorders Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: Karl
authors.initials: K
authors.lastname: Doghramji
authors.affiliation: 1 Thomas Jefferson University Department of Otolaryngology-Head & Neck Surgery, Philadelphia, Pennsylvania, USA.
authors.forename: Maurits
authors.initials: M
authors.lastname: Boon
mesh_terms: D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*
keywords: obstructive sleep apnea; sleep apnea; sleep disordered breathing; sleep surgery