Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.
Laryngoscope. 2013 Nov;123(11):2896-9. doi: 10.1002/lary.24045. Epub 2013 Aug 5.
OBJECTIVES/HYPOTHESIS: We evaluated the change in upper airway collapse according to the depth of sedation during drug-induced sleep endoscopy (DISE), as well as characteristics possibly associated with that change.
Prospective, single center, observational study.
Twenty-nine patients with upper airway collapse were twice evaluated using DISE according to the depth of sedation, as confirmed by the bispectral index (BIS), which is a measure of the level of consciousness. Changes in the site and degree of obstruction according to the change in sedation depth at the retropalatal and the retroglossal levels were evaluated. The possible contributing factors of this change were explored.
As DISE sedation deepened, the upper airway became narrower in 37% of patients at the retropalatal level and in 44.8% of patients at the retroglossal level. No clinical, polysomnographic, or cephalometric variables showed any association with the change in the degree of retroglossal airway narrowing, with the exception of mouth breathing during DISE.
The degree of upper airway narrowing can be aggravated according to the sedation depth. The monitoring of sedation depth during DISE is critical, especially in patients with mouth breathing.
目的/假设：我们评估了药物诱导睡眠内镜（DISE）过程中镇静深度对上气道塌陷的变化，以及可能与这种变化相关的特征。
前瞻性、单中心、观察性研究。
29 例上气道塌陷患者根据意识水平的测量指标双频谱指数（BIS）进行两次 DISE 评估，以确认镇静深度。评估了在软腭后和会厌后水平，根据镇静深度的变化，阻塞部位和程度的变化。探讨了这种变化的可能影响因素。
随着 DISE 镇静的加深，37%的患者在软腭后水平和 44.8%的患者在会厌后水平上气道变窄。除了 DISE 期间口呼吸外，没有临床、多导睡眠图或头影测量变量与会厌后气道狭窄程度的变化有任何关联。
根据镇静深度，上气道狭窄程度可能会加重。DISE 期间镇静深度的监测至关重要，尤其是在口呼吸的患者中。
