Drug induced sleep endoscopy – does a local fi nding in the upper respiratory tract correspond to the severity of sleep apnea syndrome?

Authors: J. Kalhous- 1 3;  J. Kordík 2
Authors‘ workplace: Klinika ORL a chirurgie hlavy a krku, UJEP, Masarykova nemocnice o. z., Ústí nad Labem, Krajská zdravotní a. s. 1;  Centrum pro poruchy dýchání ve, spánku, Masarykova nemocnice o. z., Ústí nad Labem, Krajská zdravotní a. s. 2;  UK Hradec Králové 3
Published in: Cesk Slov Neurol N 2021; 84/117(2): 179-182
Category: Original Paper
doi: 10.48095/cccsnn2021179


Aim: Obstructive sleep apnea syndrome (OSAS) is a common disease in the Czech Republic, and the methods of treatment are positive airway pressure or surgical treatment. Drug induced sleep endoscopy (DISE) is a standard part of the OSAS dia­gnostic protocol, helping the surgeon determine the site of obstruction in the upper respiratory tract. In our work we deal with the association between the OSAS severity and a local finding in the upper respiratory tract. Materials and Methods: In this work we evaluate a group of 94 patients who underwent DISE. Patients were divided into 3 groups according to the OSAS severity. Group 1 – mild OSAS (apnea-hypopnea index [AHI] 0–14.9), group 2 – moderate severe OSAS (AHI 15–29.9), and group 3 – severe OSAS (AHI ≥ 30). We determined the local finding according to the VOTE classification, i.e., specifically for the sub-localities of the soft palate, oropharynx, tongue root, and epiglottis. We evaluated whether the degree of obstruction in the upper airway was related to the OSAS severity expressed by AHI. We used the Chi-square test for statistical evaluation of individual sub-localities. Results: An association between the degree of obstruction and AHI was found in the areas of the soft palate (Pearson Chi-square: 25.1982; P = 0.000046), oropharynx (Pearson Chi-square: 58.2373; P = 0.000001) and in the area of the tongue (Pearson Chi-square: 15.3935; P = 0.000455). In the area of the epiglottis, no association between the degree of obstruction and AHI was found (Pearson Chi-square: 2.74484; P = 0.601393). Conclusion: DISE is an integral part of the OSAS dia­gnostic protocol. In our work we showed that the degree of obstruction in 3 out of 4 sub-localities (soft palate, oropharynx, root tongue) corresponded with the OSAS severity. Thus, it is possible to predict the degree of obstruction in the upper respiratory tract area according to the level of AHI, with the exception of the epiglottis area.


drug induced sleep endoscopy – VOTE – NOHL – obstructive sleep apnea syndrome


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Paediatric neurology Neurosurgery Neurology

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