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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2017; 71(3): 193–198. doi:10.14735/amgh2017193.

Drug-induced sleep endoscopy – targeted endoscopic diagnosis in patients with obstructive sleep apnea

Jaroslava Hybášková1,2, Ondřej Jor3, Vilém Novák4, Petr Matoušek1,2, Pavel Komínek1,2

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Summary

Aims: Obstructive sleep apnea (OSA) is characterized by repetitive pauses in breathing during sleep, despite the effort to breathe, and is caused by obstruction of the upper airway. Determining the location of the upper airway obstruction is a diagnostic and therapeutic challenge. Methods: Seventy-one patients with OSA (9 women and 62 men) underwent awake examination with nasendoscopy and drug-induced sleep endoscopy (DISE). Collapse of the upper airway during wakefulness and DISE was compared. Indications for surgery according to otorhinolaryngology examination before and after DISE were also compared. Results: During wakefulness and DISE, palatal collapse was different in 30.1% (22/71), oropharyngeal collapse in 66.2% (47/71), tongue base collapse in 39.4% (28/71), and laryngeal collapse in 32.4% (23/71) patients. After DISE, the surgical plan was changed in 66.2% (47) of the patients. Conclusions: In patients with OSA, DISE helps to identify the site of upper airway obstruction more accurately. The larynx plays an important role in OSA. Furthermore, DISE changes surgical decision-making compared with awake evaluation methods.

Keywords

epiglottis, flexible endoscopy, horní cesty dýchací, obstructive sleep apnea, drug-induced sleep endoscopy

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