Advances in the Role of Drug-Induced Sleep Endoscopy in Investigating Sleep Apnea

Advances in the Role of Drug-Induced Sleep Endoscopy in Investigating Sleep Apnea Purpose of Review Our aim is to highlight the current ad- sessment of the upper airway in patients diagnosed with OSA vances and the role of drug-induced sleep endoscopy (DISE) and is essential to determine site-specific treatment and indi- in investigating sleep apnea. vidual patient management. Management of OSA is slowly Recent Findings Since drug-induced sleep is not necessarily moving away from CPAP treatment only, and evidence is identical to natural sleep, proper level of sedation is important. rising that assessment with DISE changes surgical and non- When using propofol, clinically useful determinations of air- surgical treatment planning and increases treatment outcome. way obstruction seem to occur at medium sedation, which is most probably achieved with a blood propofol concentration Keywords Obstructive sleep apnea Drug-induced sleep . . . of 3.2 μg/ml. Historically, recommendations were to perform endoscopy Manoeuvres Surgical treatment outcome DISE in the worse sleeping position, which is almost always Non-surgical treatment outcome the supine position. In positional dependent obstructive sleep apnea (POSA), evaluation of the upper airway in lateral posi- tion becomes more important and can be mimicked by lateral Introduction head rotation alone. Simulation bites and systems as the ma- trix provide higher accuracy to http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Otorhinolaryngology Reports Springer Journals

Advances in the Role of Drug-Induced Sleep Endoscopy in Investigating Sleep Apnea

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Publisher
Springer US
Copyright
Copyright © 2017 by Springer Science+Business Media, LLC
Subject
Medicine & Public Health; Otorhinolaryngology
eISSN
2167-583X
D.O.I.
10.1007/s40136-017-0160-6
Publisher site
See Article on Publisher Site

Abstract

Purpose of Review Our aim is to highlight the current ad- sessment of the upper airway in patients diagnosed with OSA vances and the role of drug-induced sleep endoscopy (DISE) and is essential to determine site-specific treatment and indi- in investigating sleep apnea. vidual patient management. Management of OSA is slowly Recent Findings Since drug-induced sleep is not necessarily moving away from CPAP treatment only, and evidence is identical to natural sleep, proper level of sedation is important. rising that assessment with DISE changes surgical and non- When using propofol, clinically useful determinations of air- surgical treatment planning and increases treatment outcome. way obstruction seem to occur at medium sedation, which is most probably achieved with a blood propofol concentration Keywords Obstructive sleep apnea Drug-induced sleep . . . of 3.2 μg/ml. Historically, recommendations were to perform endoscopy Manoeuvres Surgical treatment outcome DISE in the worse sleeping position, which is almost always Non-surgical treatment outcome the supine position. In positional dependent obstructive sleep apnea (POSA), evaluation of the upper airway in lateral posi- tion becomes more important and can be mimicked by lateral Introduction head rotation alone. Simulation bites and systems as the ma- trix provide higher accuracy to

Journal

Current Otorhinolaryngology ReportsSpringer Journals

Published: Aug 12, 2017

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