Awake Versus Drug-induced Sleep Endoscopy: Evaluation of Airway Obstruction in Obstructive Sleep Apnea/hypopnoea Syndrome

Overview

Journal Laryngoscope

Specialty Otorhinolaryngology

Date 2013 Oct 30

PMID 24167821

Citations 37

Authors

Matteo Cavaliere

Federico Russo

Maurizio Iemma

Affiliations

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Abstract

Objectives/hypothesis: To compare the degree and patterns of upper airway obstruction, as detected by endoscopy with Müller's maneuver versus drug-induced sleep endoscopy (DISE).

Methods: Sixty-six patients (60 males and 6 females), with a mean age of 49.59 ± 13.04 years, underwent videonasal-pharyngo-laryngoscopy to asses anatomy and dynamic behavior of upper airways during the Müller's maneuver awake, and during DISE by Propofol with boluses refracted technique.

Results: In the majority of our patients, we detected an obstruction due to nasal septal deviation (91%) and turbinate hypertrophy (100%). The pattern of the obstruction caused by the soft palate and the tongue base was similar in DISE and Müller's maneuver, whereas the registered degree was significantly higher in DISE. Concerning the larynx, 22.7% of patients showed an involvement of the epiglottis during sedation that was not assessable during wakefulness.

Conclusions: DISE is a simple additional tool to plan surgical treatment in patients with OSAHS, and in our hands has proven to be more accurate and precise than endoscopy with Müller's maneuver.

Citing Articles

Characterization of Patients With Obstructive Sleep Apnea Syndrome Undergoing Drug-Induced Sleep Endoscopy: A Retrospective Study of Nine Years (2014-2022).

Araujo Martins M, Lombo C, Mota C, Pinto C, Moura R, Fonseca R Cureus. 2025; 17(2):e78811.

PMID: 40078236 PMC: 11902910. DOI: 10.7759/cureus.78811.

The role of positional changes in optimizing OSA treatment: evidence from DISE.

Mladonova M, Fedorova K, Jor O, Slonkova J, Konde A, Kominek P Eur Arch Otorhinolaryngol. 2025; .

PMID: 40064683 DOI: 10.1007/s00405-025-09314-y.

Relationship of Upper Airway Collapse with Severity of Sleep Apnoea and Sleepiness.

Kurien R, Rebekah G, Varghese L Indian J Otolaryngol Head Neck Surg. 2023; 75(2):469-473.

PMID: 37274973 PMC: 10235394. DOI: 10.1007/s12070-022-03297-6.

Sleep Endoscopy with Positive Airway Pressure: A Method for Better Compliance and Individualized Treatment of Patients with Obstructive Sleep Apnea.

Masarova M, Matousek P, Jor O, Novak V, Vrtkova A, Kubec V Life (Basel). 2022; 12(12).

PMID: 36556473 PMC: 9788266. DOI: 10.3390/life12122108.

Determining the Site of Upper Airway Narrowing in Snorers Using a Noninvasive Technique.

Alhejaili F, Wali S, Abosoudah S, Mufti H, Marzouki H, Ismail A Cureus. 2022; 14(9):e28659.

PMID: 36196292 PMC: 9526191. DOI: 10.7759/cureus.28659.