Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121, Forlì, Italy.
Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy.
Sleep Breath. 2022 Dec;26(4):1621-1632. doi: 10.1007/s11325-021-02528-4. Epub 2021 Nov 20.
To observe the effectiveness of preoperative drug-induced sleep endoscopy in improving surgical results of patients undergoing single-level barbed pharyngoplasty surgery for OSA, using a prospective randomized model.
A single-center randomized controlled trial with two prospective arms was carried out to compare functional results in patients treated with barbed reposition pharyngoplasty (BRP) surgery without a preoperative drug-induced sleep endoscopy (DISE) evaluation vs patients treated with BRP surgery performed after DISE evaluation of sites/patterns of collapse.
We compared 50 patients who underwent BRP without a preoperative DISE evaluation (Group A) and 42 patients (Group B) treated with BRP surgery but preoperatively selected by means of a preoperative DISE. In this second group of patients, after DISE evaluation, 70% of patients were selected for single-level BRP surgery because they showed an isolated velopharyngeal collapse at the DISE evaluation, without obstruction at other upper airway levels evaluated. Both groups of patients showed a statistically significant difference between preoperative and postoperative values of AHI, ODI, and LOS (p<0.05 in all cases). Comparing Group A and Group B patients, the therapeutic success rate was found to be 60% in patients treated without preoperative DISE evaluation and 83% in patients treated with preoperative DISE (p = 0.02).
DISE appears to improve the surgical results of single-level velopharyngeal surgery due to the possibility of excluding patients with obstruction of the base of the tongue, the hypopharynx, and the epiglottis/larynx.
采用前瞻性随机模型，观察术前药物诱导睡眠内镜（DISE）在提高行单平面带刺咽成形术（BRP）治疗 OSA 患者手术效果中的作用。
进行了一项单中心、随机对照试验，设有两个前瞻性组，比较了未经 DISE 评估的带刺再定位咽成形术（BRP）治疗患者（A 组）与 DISE 评估部位/塌陷模式后行 BRP 手术治疗患者（B 组）的功能结果。
我们比较了 50 例行 BRP 且未行术前 DISE 评估的患者（A 组）和 42 例行 BRP 但术前通过 DISE 选择的患者（B 组）。在第二组患者中，70%的患者在 DISE 评估后选择行单平面 BRP 手术，因为他们在 DISE 评估中仅显示软腭塌陷，而其他上气道水平没有阻塞。两组患者的 AHI、ODI 和 LOS 的术前和术后值均有统计学显著差异（p<0.05）。比较 A 组和 B 组患者，未行术前 DISE 评估的患者治疗成功率为 60%，而行术前 DISE 的患者治疗成功率为 83%（p = 0.02）。
DISE 似乎可以提高单平面软腭手术的手术效果，因为它可以排除舌根、咽和会厌/喉阻塞的患者。
