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J S Park, D K Chan, S R Parikh, A K Meyer, K W Rosbe
OBJECTIVE: To study the efficacy of surgical management for obstructive sleep apnea (OSA) syndrome in children with hypotonia, and to identify common anatomic sites of airway obstruction. METHODS: Retrospective chart review of polysomnographic parameters and quality of life instrument scores for seventy eight children with hypotonia who underwent surgical intervention for sleep-disordered breathing at two tertiary children's hospitals, and analysis of drug-induced sleep endoscopy data using a previously validated scoring system...
November 2016: International Journal of Pediatric Otorhinolaryngology
Natamon Charakorn, Eric J Kezirian
Drug-induced sleep endoscopy (DISE) is an upper airway evaluation technique in which fiberoptic examination is performed under conditions of unconscious sedation. Unique information obtained from this 3-dimensional examination of the airway potentially provides additive benefits to other evaluation methods to guide treatment selection. This article presents recommendations regarding DISE technique and the VOTE Classification system for reporting DISE findings and reviews the evidence concerning DISE test characteristics and the association between DISE findings and treatment outcomes...
October 6, 2016: Otolaryngologic Clinics of North America
Soo Kweon Koo, Soon Bok Kwon, Yang Jae Kim, J I Seung Moon, Young Jun Kim, Sung Hoon Jung
Snoring is a sign of increased upper airway resistance and is the most common symptom suggestive of obstructive sleep apnea. Acoustic analysis of snoring sounds is a non-invasive diagnostic technique and may provide a screening test that can determine the location of obstruction sites. We recorded snoring sounds according to obstruction level, measured by DISE, using a smartphone and focused on the analysis of formant frequencies. The study group comprised 32 male patients (mean age 42.9 years). The spectrogram pattern, intensity (dB), fundamental frequencies (F 0), and formant frequencies (F 1, F 2, and F 3) of the snoring sounds were analyzed for each subject...
October 5, 2016: European Archives of Oto-rhino-laryngology
Sung Hoon Jung, Soo Kweon Koo, Jang Won Choi, Ji Seung Moon, Sang Hoon Lee
We studied upper airway structural changes induced by continuous positive airway pressure (CPAP) in obstructive sleep apnea syndrome (OSAS) patients using drug-induced sleep endoscopy (DISE). This prospective study was conducted at an academic secondary referral center. In total, 28 male OSAS patients (mean age 41.1 years) with only retropalatal level obstructions were enrolled. Measurements of the obstruction site were obtained in two steps: first a measurement was taken of the obstruction site in accordance with sleep apnea, then, a measurement was taken of the obstruction site in accordance with DISE-assisted CPAP titration, including quantitative changes in the occlusion site before and after CPAP in pixel format using an area calculation program...
July 29, 2016: European Archives of Oto-rhino-laryngology
Li-Ang Lee, Yu-Lun Lo, Jen-Fang Yu, Gui-She Lee, Yung-Lun Ni, Ning-Hung Chen, Tuan-Jen Fang, Chung-Guei Huang, Wen-Nuan Cheng, Hsueh-Yu Li
Snoring sounds generated by different vibrators of the upper airway may be useful indicators of obstruction sites in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). This study aimed to investigate associations between snoring sounds, obstruction sites, and surgical responses (≥50% reduction in the apnea-hypopnea index [AHI] and <10 events/hour) in patients with OSAHS. This prospective cohort study recruited 36 OSAHS patients for 6-hour snoring sound recordings during in-lab full-night polysomnography, drug-induced sleep endoscopy (DISE), and relocation pharyngoplasty...
2016: Scientific Reports
Christopher Clark, Seckin O Ulualp
OBJECTIVES/HYPOTHESIS: Children with obstructive sleep apnea (OSA) may have multiple sites of upper airway obstruction (UAO). A wide variety of techniques has been used to evaluate UAO. Our aim was to compare findings of cine magnetic resonance imaging (MRI) and drug-induced sleep endoscopy (DISE) in identifying UAO sites in children with persistent OSA after adenotonsillectomy (AT). STUDY DESIGN: Retrospective chart review. MATERIAL AND METHODS: The medical records of children who underwent DISE and cine MRI were reviewed...
July 14, 2016: Laryngoscope
Yakup Yegïn, Mustafa Çelik, Kamïl Hakan Kaya, Arzu Karaman Koç, Fatma Tülin Kayhan
INTRODUCTION: Knowledge of the site of obstruction and the pattern of airway collapse is essential for determining correct surgical and medical management of patients with Obstructive Sleep Apnea Syndrome (OSAS). To this end, several diagnostic tests and procedures have been developed. OBJECTIVE: To determine whether drug-induced sleep endoscopy (DISE) or Müller's maneuver (MM) would be more successful at identifying the site of obstruction and the pattern of upper airway collapse in patients with OSAS...
June 20, 2016: Brazilian Journal of Otorhinolaryngology
Jack W Shteamer, Raj C Dedhia
OBJECTIVE: To examine the suitability of commonly used agents for drug-induced sleep endoscopy (DISE) based on agent-specific neuropharmacology. DATA SOURCES: PubMed. REVIEW METHODS: A literature search of the PubMed database was performed on January 1, 2016. A two-layered search strategy was performed to identify relevant pharmacologic agents and articles related to neuropharmacology for these agents. The first search identified relevant pharmacologic agents; the second search examined agents with greater than five results from search 1, along with medical subject headings "respiration," "sleep," "pharmacology," and/or "[respective agent] (e...
July 1, 2016: Laryngoscope
Stanley Yung-Chuan Liu, Leh-Kiong Huon, Tomonori Iwasaki, Audrey Yoon, Robert Riley, Nelson Powell, Carlos Torre, Robson Capasso
OBJECTIVES: To use drug-induced sedation endoscopy (DISE) and computational fluid dynamics (CFD) modeling to study dynamic airway and airflow changes after maxillomandibular advancement (MMA), and how the changes correlate with surgical success based on polysomnography parameters. STUDY DESIGN: Retrospective cohort study. SETTING: University medical center. METHODS: DISE was rated with the VOTE (velum, oropharynx, tongue, epiglottis) classification, and CFD was used to model airflow velocity and negative pressure exerted on pharyngeal wall...
January 2016: Otolaryngology—Head and Neck Surgery
Victor F Certal, Rui Pratas, Lidia Guimarães, Rodolfo Lugo, Yungan Tsou, Macario Camacho, Robson Capasso
OBJECTIVE: Traditionally, upper airway examination is performed while the patient is awake. However, in the past two decades, drug-induced sleep endoscopy (DISE) has been used as a method of tridimensional evaluation of the upper airway during pharmacologically induced sleep. This study aimed to systematically review the evidence regarding the usefulness of DISE compared with that of traditional awake examination for surgical decision making in patients with obstructive sleep apnea (OSA)...
March 2016: Laryngoscope
Byung-Woo Yoon, Jeong-Min Hong, Sung-Lyong Hong, Soo-Kweon Koo, Hwan-Jung Roh, Kyu-Sup Cho
OBJECTIVES/HYPOTHESIS: In this study, we compared the effects of propofol and dexmedetomidine on the upper airway collapse pattern and cardiopulmonary parameters of patients with obstructive sleep apnea (OSA) undergoing drug-induced sleep endoscopy (DISE). STUDY DESIGN: Prospective, single center, observational study MATERIALS AND METHODS: The 50 patients with OSA underwent 30 minutes of DISE on 2 different days, the first time with propofol target-controlled infusion (TCI) and the second time with dexmedetomidine TCI...
March 2016: Laryngoscope
Robson Capasso, Talita Rosa, David Yung-An Tsou, Vladimir Nekhendzy, David Drover, Jeremy Collins, Soroush Zaghi, Macario Camacho
OBJECTIVE: To compare VOTE classification findings (velum, oropharyngeal-lateral walls, tongue base, and epiglottis) for drug-induced sleep endoscopy (DISE) among patients with obstructive sleep apnea (OSA) using 2 sedation protocols. STUDY DESIGN: Case series with chart review. SETTING: Single tertiary institution. SUBJECTS: Patients with OSA who underwent DISE. METHODS: A total of 216 patients underwent DISE between November 23, 2011, and May 1, 2015...
April 2016: Otolaryngology—Head and Neck Surgery
John P Dahl, Craig Miller, Patricia L Purcell, David A Zopf, Kaalan Johnson, David L Horn, Maida L Chen, Dylan K Chan, Sanjay R Parikh
OBJECTIVE: To determine if standardized intraoperative scoring of anatomic obstruction in children with obstructive sleep apnea correlates with the apnea-hypopnea index (AHI) and lowest oxygen saturation on preprocedural polysomnogram (PSG). A secondary objective was to determine if age, presence of a syndrome, or previous adenotonsillectomy affect this correlation. STUDY DESIGN: Case series with chart review. SETTING: Two tertiary care children's hospitals...
October 2016: Otolaryngology—Head and Neck Surgery
Norman R Friedman, Sanjay R Parikh, Stacey L Ishman, Amanda G Ruiz, Hamdy El-Hakim, Seckin O Ulualp, Christopher T Wootten, Peter J Koltai, Dylan K Chan
OBJECTIVES/HYPOTHESIS: The purpose of this investigation was to assess current drug-induced sleep endoscopy (DISE) practice patterns at centers that have published on the technique, to identify areas of agreement, and to identify areas of disagreement that may represent opportunities for improvement and standardization. STUDY DESIGN: Multi-institutional survey. METHODS: A survey was designed in two phases to evaluate preoperative assessment, intraoperative performance, and postoperative management of patients undergoing DISE...
June 16, 2016: Laryngoscope
Adrian A Ong, Alexander W Murphey, Shaun A Nguyen, Ryan J Soose, B Tucker Woodson, Olivier M Vanderveken, Nico de Vries, M Boyd Gillespie
OBJECTIVE: To describe upper airway collapse patterns observed on drug-induced sedation endoscopy (DISE) during screening for a clinical trial and to evaluate the impact of collapse patterns found on preoperative DISE on response rates to upper airway stimulation (UAS) therapy. STUDY DESIGN: Retrospective review of an ongoing prospective multi-institutional cohort study. SETTING: Twenty-two participating institutions of the STAR trial. SUBJECTS AND METHOD: In total, 222 subjects were screened with DISE to determine eligibility for an implantable UAS device...
May 2016: Otolaryngology—Head and Neck Surgery
Ali Kandil, Rajeev Subramanyam, Mohamed Monir Hossain, Stacey Ishman, Sally Shott, Anurag Tewari, Mohamed Mahmoud
AIM: Examination of dynamic airway collapse in patients with obstructive sleep apnea (OSA) during drug-induced sleep endoscopy (DISE) can help identify the anatomic causes of airway obstruction. We hypothesized that a combination of dexmedetomidine and ketamine (Group DK) would result in fewer oxygen desaturations and a higher successful completion rate during DISE in children with OSA when compared to propofol (Group P) or sevoflurane/propofol (Group SP). METHODS: In this retrospective study, we reviewed the records of 59 children who presented for DISE between October 2013 and March 2015...
July 2016: Paediatric Anaesthesia
Soo Kweon Koo, Gun Young Ahn, Jang Won Choi, Young Jun Kim, Sung Hoon Jung, Ji Seung Moon, Young Il Lee
INTRODUCTION: The key to successful treatment of OSAS is to individually tailor such treatment. Thus, it is very important to determine the severity of OSAS, its pattern, and the extent of collapse, by gender, age, and BMI. OBJECTIVE: The objective of the study was to understand the characteristics of obstructive sleep apnea in postmenopausal women by comparing postmenopausal and premenopausal subjects, and men, using DISE. We hope that our work will help the medical community to consult on, diagnose, and treat OSAS more effectively...
April 25, 2016: Brazilian Journal of Otorhinolaryngology
Alonço da Cunha Viana, Daniella Leitão Mendes, Lucas Neves de Andrade Lemes, Luiz Claudio Santos Thuler, Denise Duprat Neves, Maria Helena de Araújo-Melo
Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete collapse of the pharynx that result in a decrease in oxyhemoglobin saturation. Nasofibrolaryngoscopy under induced sleep is a promising alternative for identifying sites of upper airway obstruction in patients with OSA. This study aimed to compare the obstruction sites screened by drug-induced sleep endoscopy (DISE) using the Nose oropharynx hypopharynx and larynx (NOHL) and Velum oropharynx tongue base epiglottis (VOTE) classifications...
May 10, 2016: European Archives of Oto-rhino-laryngology
Rajeev Subramanyam, Robert Fleck, John McAuliffe, Rupa Radhakrishnan, Dorothy Jung, Mario Patino, Mohamed Mahmoud
BACKGROUND AND OBJECTIVES: Children with Down Syndrome are vulnerable to significant upper airway obstruction due to relative macroglossia and dynamic airway collapse. The objective of this study was to compare the upper airway dimensions of children with Down Syndrome and obstructive sleep apnea with normal airway under dexmedetomidine sedation. METHODS: IRB approval was obtained. In this retrospective study, clinically indicated dynamic sagittal midline magnetic resonance images of the upper airway were obtained under low (1mcg/kg/h) and high (3mcg/kg/h) dose dexmedetomidine...
July 2016: Revista Brasileira de Anestesiologia
Patrick Kellner, Beatrice Herzog, Sebastian Plößl, Christian Rohrmeier, Thomas Kühnel, Ramona Wanzek, Stefan Plontke, Michael Herzog
PURPOSE: Drug-induced sedation endoscopy (DISE) and simulated snoring (SimS) can locate the site of obstruction in patients with sleep-disordered breathing (SDB). There is clinical evidence for a change in collapsibility of the upper airway depending on the depth of sedation. So far, a dose-response relationship between sedation and collapsibility has not been demonstrated. METHODS: DISE and SimS were performed in 60 consecutive patients with SDB under monitoring of depth of sedation by BiSpectral Index® (BIS)...
September 2016: Sleep & Breathing, Schlaf & Atmung
2016-05-14 06:38:34
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