Drug Induced Sleep Endoscopy

by De Vito Andrea

The main pathologic event which characterizes Obstructive Sleep Apnea (OSA) is the partial (hypopnea) or complete (apnoea) occlusion of the upper airways (UA). Consequently, UA assessment is necessary for the carefully selection of the surgical and no-surgical treatment options (CPAP, Oral devices, drug therapy). There are numerous techniques available for the UA evaluation, such as imaging, acoustic analysis, pressure transducer recording and UA endoscopy. It is essential to note that the nocturnal UA obstruction has limited muscle control compared to the tone of the upper airway lumen during wakefulness. Thus, it is of pivotal importance that the UA evaluation must be performed when the patient is awake and during sleep. Drug induced sleep endoscopy (DISE) represents an universally accepted UA endoscopic technique applied to OSA patients, which allows identifying the sites and patterns of partial or complete UA occlusion and compares it with the awake UA evaluation. Since its introduction in 1990, the nomenclature and the technique has been modified by various Institutions but the core value of this evaluation technique remains similar and extremely useful for the analysis of the adult and paediatric OSA patients. This oral presentation will look at DISE usefulness and advantages and will discuss some important contributions made to the field of UA evaluation in patients affected by OSA.

Learning Objectives

After this lecture, you will be able to understand the DISE main indications
After this lecture, you will be able to understand how to perform the DISE
After this lecture, you will be able to understand the advantages and usefulness of DISE application in OSA patients