Drug-induced sleep endoscopy in sleep-disordered breathing : report on 1249 cases
Vroegop, Anneclaire V.M.T.
Faculty of Medicine and Health Sciences
The laryngoscope / American Laryngological, Rhinological and Otological Society. - St.Louis, Mo.
, p. 797-802
University of Antwerp
Objective: To describe upper airway (UA) collapse patterns during drug-induced sleep endoscopy (DISE) in a large cohort of patients with sleep-disordered breathing (SDB) and to assess associations with anthropometric and polysomnographic parameters. Study design: Observational study Methods: 1,249 patients [age 47±10 y; apneahypopnea index (AHI) 18.9±15.3/h; body mass index (BMI) 27.2±3.7 kg/m²] underwent polysomnography and DISE. DISE findings were categorized to the following UA levels: palate, oropharynx, tongue base and hypopharynx. The degree of collapse was reported as complete, partial or none, and the pattern of the obstruction was described as anteroposterior, lateral or concentric. Associations between DISE findings and anthropometric and polysomnographic parameters were analyzed. Results: Palatal collapse was seen most frequently (81%). Multilevel collapse was noted in 68.2% of all patients. The most frequently observed multilevel collapse pattern was a combination of palatal and tongue base collapse (25.5%). Palatal collapse was seen most frequently (81%). The prevalence of complete collapse, multilevel collapse and hypopharyngeal collapse increased with increasing severity of obstructive sleep apnea (OSA). Multilevel and complete collapse were more prevalent in obese patients and in those with more severe OSA. Both higher BMI and AHI values were associated with a higher probability of complete concentric palatal collapse. Conclusion: The current study provides an overview of UA collapse patterns in a large cohort of SDB patients who underwent DISE. The associations found in this study may indicate that UA collapse patterns observed during DISE cannot be fully explained by selected baseline polysomnographic and anthropometric characteristics