Ghosh Sampurna, Kishore Srinivas
Medicover Hospitals, Hyderabad, India.
AIG Hospitals, Hyderabad, India.
Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):30-35. doi: 10.1007/s12070-023-04052-1. Epub 2023 Jul 27.
The aim of this study was to analyze drug-induced sleep endoscopy (DISE) findings performed in 64 patients and to evaluate the association of DISE findings with PSG parameters. This retrospective, single center, observational study included patients with obstructive sleep apnoea (OSA) who have undergone DISE as part of surgical planning. DISE was performed using dexmedetomidine infusion. The data were documented as per VOTE (velum, oropharynx, tongue base and epiglottis) classification. The patient characteristics and level 2 Polysomnography (PSG) findings were analyzed with DISE findings. Among 62 patients, mean AHI and lowest oxygen saturation levels were 39.68 ± 27.59 and 78.36 ± 9.38, respectively. Mean ESS, SSS and PSQI levels were 10.74 ± - 4.96, 7.73 ± - 1.52, and 8.92 +/- 4.99, respectively. A Single level of obstruction was observed in 4.8% patients, followed by 40.3%, 43.5%, and 11.3% were found to have 2, 3, and 4 levels of obstruction, respectively. All patients had palatal involvement, followed by the oropharyngeal (88.7%), the tongue base (59.7%), and the epiglottis (12.9%) obstruction. There was no significant correlation between partial collapse at velopharynx with AHI. However, complete collapse at the level of the oropharynx ( < 0.05) and the tongue base ( < 0.001) showed a statistically significant association with AHI. Also, a significant correlation was observed between the number of sites and AHI Grade ( < 0.0001). The study helps to understand the association of different patterns and degrees of anatomical obstruction in OSA with different PSG parameters. PSG and DISE findings are complimentary to each other in treatment planning and selection of surgical procedures.
本研究的目的是分析64例患者的药物诱导睡眠内镜检查(DISE)结果,并评估DISE结果与多导睡眠图(PSG)参数之间的关联。这项回顾性、单中心观察性研究纳入了作为手术规划一部分接受DISE检查的阻塞性睡眠呼吸暂停(OSA)患者。DISE采用右美托咪定输注进行。数据按照VOTE(软腭、口咽、舌根和会厌)分类记录。将患者特征与二级多导睡眠图(PSG)结果与DISE结果进行分析。62例患者中,平均呼吸暂停低通气指数(AHI)和最低血氧饱和度水平分别为39.68±27.59和78.36±9.38。平均爱泼沃斯思睡量表(ESS)、鼾症量表(SSS)和匹兹堡睡眠质量指数(PSQI)水平分别为10.74±4.96、7.73±1.52和8.92±4.99。4.8%的患者观察到单水平阻塞,其次分别有40.3%、43.5%和11.3%的患者被发现有2、3和4个水平的阻塞。所有患者均有腭部受累,其次是口咽部阻塞(88.7%)、舌根阻塞(59.7%)和会厌阻塞(12.9%)。腭咽部分塌陷与AHI之间无显著相关性。然而,口咽部(<0.05)和舌根水平(<0.001)的完全塌陷与AHI存在统计学显著关联。此外,观察到阻塞部位数量与AHI分级之间存在显著相关性(<0.0001)。该研究有助于了解OSA中不同模式和程度的解剖学阻塞与不同PSG参数之间的关联。PSG和DISE结果在治疗规划和手术程序选择方面相互补充。