Presented in part at the Trilogical Society Combined Sections Meeting, January 26-28, 2012. Miami Beach, Florida.
Article first published online: 10 SEP 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 11, pages 2592–2599, November 2012
How to Cite
Borek, R. C., Thaler, E. R., Kim, C., Jackson, N., Mandel, J. E. and Schwab, R. J. (2012), Quantitative airway analysis during drug-induced sleep endoscopy for evaluation of sleep apnea. The Laryngoscope, 122: 2592–2599. doi: 10.1002/lary.23553
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 25 OCT 2012
- Article first published online: 10 SEP 2012
- Manuscript Accepted: 7 JUN 2012
- Manuscript Revised: 3 MAY 2012
- Manuscript Received: 12 JAN 2012
- Obstructive sleep apnea;
- drug-induced sleep endoscopy;
- quantitative analysis;
- sleep nasendoscopy;
- upper airway collapse;
- Level of Evidence: 4
To quantitatively measure changes in airway caliber at multiple anatomical levels during drug-induced sleep endoscopy (DISE) for evaluation of sleep apnea. We hypothesize that patients undergoing DISE will show: 1) collapse at multiple upper airway regions (retropalatal, retroglossal, and retroepiglottic), with greater collapse in the retropalatal region; and 2) greater anterior-posterior dimensional narrowing than the lateral.
Patients underwent DISE employing propofol as part of a nonrandomized prospective trial assessing candidacy for transoral robotic surgery intervention for sleep apnea. Images of the retropalatal, retroglossal, and retroepiglottic regions were captured during an initial period of light sedation and again in a period of deep sedation. Images were analyzed using software to measure the percent change in regional airway measurements as a result of DISE.
Thirty-seven sleep endoscopy videos were analyzed from patients with obstructive sleep apnea (apnea-hypopnea index: 42.9 ± 27.0 events/hour). Analyzable images were in the retropalatal (n = 24), retroglossal (n = 27), and retroepiglottic (n = 29) regions. The patients demonstrated mean reductions in airway area in the retropalatal (84.1 ± 18.7%), retroglossal (39.3 ± 37.5%), and retroepiglottic region (44.6 ± 42.8%). No statistically significant differences were found between lateral and anterior-posterior airway dimensional changes.
Patients undergoing DISE had significant reductions in airway area at multiple regions under deep sedation with propofol. We conclude that collapse in the retropalatal region is greater than the hypopharyngeal region. This method can be used to quantitatively measure DISE upper airway changes, which could potentially be used as a means for understanding surgical outcomes in patients with sleep apnea. Laryngoscope, 2012