European position paper on drug-induced sleep endoscopy: 2017 Update

De Vito, Andrea; Carrasco Llatas, Marina; Ravesloot, Madeline J L; Kotecha, Bhik; de Vries, Nico; Hamans, Evert; Maurer, Joachim T; Bosi, Marcello; Blumen, Marc; Heiser, Clemens; Herzog, Michael E; Montevecchi, Filippo; Corso, Ruggero Massimo; Braghiroli, Alberto; Gobbi, Riccardo Gomes; Vroegop, Anneclaire V.M.T.; Vonk, Patty Elisabeth; Hohenhorst, Winfried; Piccin, Ottavio; Sorrenti, Giovanni; Vanderveken, Olivier M; Vicini, Claudio

doi:10.1111/coa.13213

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European position paper on drug-induced sleep endoscopy: 2017 Update

Author(s): Andrea De Vito ¹ ^, ² , Marina Carrasco Llatas ³ , Madeline J. Ravesloot ⁴ ^, ⁵ , Bhik Kotecha ⁶ , Nico De Vries ⁷ ^, ⁸ ^, ⁹ , Evert Hamans ¹⁰ , Joachim Maurer ¹¹ , Marcello Bosi ¹² , Marc Blumen ¹³ , Clemens Heiser ¹⁴ , Michael Herzog ¹⁵ , Filippo Montevecchi ¹⁶ , Ruggero Massimo Corso ¹⁷ , Alberto Braghiroli ¹⁸ , Riccardo Gobbi ¹ , Anneclaire Vroegop ¹⁹ , Patty Elisabeth Vonk ⁴ , Winfried Hohenhorst ²⁰ , Ottavio Piccin ²¹ , Giovanni Sorrenti ²¹ , Olivier M. Vanderveken ²² , Claudio Vicini ²³ ^, ²⁴ ^, ²⁵ ^, ²⁶ ^, ²⁷

Publication date (Electronic): September 30 2018

Journal: Clinical Otolaryngology

Publisher: Wiley

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Abstract

The first edition of the European position paper (EPP) on drug-induced sleep endoscopy (DISE) was published in 2014 with the aim to standardise the procedure, to provide an in-depth insight into the main aspects of this technique and to have a basis for future research. Since 2014, new studies have been published concerning new sedative agents or new insights into the pattern/levels of the obstruction depending on the depth of sedation. Therefore, an enlarged group of European experts in the field of sleep breathing disorders (SBD), including the most of the first DISE EPP main authors, has decided to publish an update of the European position paper on DISE, in order to include new evidence and to find a common language useful for reporting the findings of this endoscopic evaluation in adult population affected by SBD.

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Most cited references 72

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Drug-induced sleep endoscopy: the VOTE classification.

Eric Kezirian, Nico Van de Weghe, W Hohenhorst (2011)

The surgical evaluation of obstructive sleep apnea is designed to characterize the pattern of upper airway obstruction in order to develop an effective treatment plan for an individual patient. Drug-induced sleep endoscopy (DISE) is one evaluation technique that involves assessment of individuals under pharmacologic sedation designed to simulate natural sleep, utilizing fiberoptic endoscopy to examine the upper airway. Developed in multiple centers throughout Europe, DISE was first described in 1991 and is performed widely around the world. Although multiple studies support a potential role for DISE in evaluation for treatment with surgery and mandibular repositioning appliances, important clinical questions remain unanswered. A major limitation in advancing our understanding of drug-induced sleep endoscopy has been the multiplicity and, in many cases, the complexity of classification systems that prevent the comparison of results across the studies and centers. We present the VOTE classification, a method for characterizing DISE findings that focuses on its core feature, the specific structures that contribute to obstruction.

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Sleep nasendoscopy: a technique of assessment in snoring and obstructive sleep apnoea.

Charles C. Croft, Robert M Pringle (1991)

It appears that uvulopalatopharyngoplasty (UVPP) is a reliable procedure for reducing snoring, but much less reliable when used as a treatment for OSAS. This is thought to be because of poor patient selection in that the site of the problem is not always the site of the operation. We present the technique of sleep nasendoscopy which allows direct visualization of the site or sites of obstruction in a sleeping patient. Our study has shown that there are patients with obstructive sleep apnoea syndrome (OSAS) in whom the only site of pharyngeal obstruction is at the velopharynx. These patients should do well with the relatively simple procedure of UVPP. This is not true for many other OSAS patients in whom we found that obstruction was multisegmental. This helps to explain the frequently poor results of UVPP in OSAS patients. We feel that this form of preoperative assessment will avoid unnecessary surgery.

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Drug-induced sleep endoscopy in sleep-disordered breathing: report on 1,249 cases.

Anneclaire Vroegop, Olivier M Vanderveken, An N Boudewyns … (2014)

To describe upper airway (UA) collapse patterns during drug-induced sleep endoscopy (DISE) in a large cohort of patients with sleep-disordered breathing (SDB) and to assess associations with anthropometric and polysomnographic parameters.

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Author and article information

Journal

Title: Clinical Otolaryngology

Abbreviated Title: Clin Otolaryngol

Publisher: Wiley

ISSN: 17494478

Publication date Created: December 2018

Publication date (Print): December 2018

Publication date (Electronic): September 30 2018

Volume: 43

Issue: 6

Pages: 1541-1552

Affiliations

[1 ]Head and Neck Department; ENT & Oral Surgery Unit; Morgagni-Pierantoni Hospital; Forlì Italy

[2 ]ENT Unit; Santa Maria delle Croci Hospital; Ravenna AUSL of Romagna; Romagna Italy

[3 ]ENT Clinic; Hospital Universitario Doctor Peset; Valencia Spain

[4 ]Department of Otorhinolaryngology and Head and Neck Surgery; OLVG; Amsterdam The Netherlands

[5 ]Medisch Centrum Jan van Goyen; Amsterdam The Netherlands

[6 ]Royal National Throat Nose & Ear Hospital; UCLH; London UK

[7 ]Department of Otolaryngology, OLVG Hospital and ACTA; Amsterdam Netherlands

[8 ]Department of Otorhinolaryngology and Head and Neck Surgery; Multidisciplinary Sleep Disorders Center; University of Antwerp; Antwerp Belgium

[9 ]Department of Oral Kinesiology; Academic Centre for Dentistry; MOVE Inst.; Amsterdam The Netherlands

[10 ]Department of Otorhinolaryngology, Head and Neck Surgery; Jan Palfijn Hospital; Ziekenhuis Netwerk Antwerpen (ZNA); Antwerpen Belgium

[11 ]Sleep Disorders Centre; Department of Otorhinolaryngology, Head and Neck Surgery; University Medicine Mannheim; Mannheim Germany

[12 ]Pulmonary Operative Unit; Department of Thoracic Diseases; Morgagni-Pierantoni Hospital; AUSL of Romagna; Forlì Italy

[13 ]Service ORL; Hopital Foch, Suresnes France and Centre Medical Veille Sommeil; Paris France

[14 ]Department of Otorhinolaryngology, Head and Neck Surgery; Technische Universitat Munchen; Munich Germany

[15 ]Department of Otorhinolaryngology, Head and Neck Surgery; Carl Thiem Klinikum; Cottbus Germany

[16 ]Head and Neck Department; ENT & Oral Surgery Unit; Morgagni-Pierantoni Hospital; AUSL of Romagna; Forlì Italy

[17 ]Intensive Care Unit; Morgagni-Pierantoni Hospital; AUSL of Romagna; Forlì Italy

[18 ]Sleep Lab. Pulmonary Rehabilitation Dept. Istituti Clinici Scientifici Maugeri; SPA SB; IRCCS; Veruno Italy

[19 ]Department of Otorhinolaryngology, Head and Neck Surgery; Antwerp University Hospital; Edegem Belgium

[20 ]ENT, Head and Neck Surgery; Alfried Krupp Hospital; Essen Germany

[21 ]Department of Otolaryngology, Head and Neck Surgery; Sant'Orsola-Malpighi University Hospital; Bologna Italy

[22 ]Faculty of Medicine and Health Sciences; University of Antwerp- Department ENT, Head and Neck Surgery; Antwerp University Hospital - Multidisciplinary Sleep Disorders Centre; Antwerp University Hospital; Antwerp Belgium

[23 ]Head and Neck Department; AUSL of Romagna; ENT & Oral Surgery Unit; Morgagni-Pierantoni Hospital; Forlì Italy

[24 ]ENT Unit; Infermi Hospital; AUSL of Romagna; Faenza Italy

[25 ]ENT Unit; Santa Maria delle Croci Hospital; Ravenna Italy

[26 ]AUSL of Romagna; Romagna Italy

[27 ]ENT Clinic; University of Ferrara; Ferrara Italy

Article

DOI: 10.1111/coa.13213

PubMed ID: 30133943

SO-VID: 0af54455-74e9-49bf-a816-da96c101b0af

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European position paper on drug-induced sleep endoscopy: 2017 Update

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Most cited references 72

Drug-induced sleep endoscopy: the VOTE classification.

Sleep nasendoscopy: a technique of assessment in snoring and obstructive sleep apnoea.

Drug-induced sleep endoscopy in sleep-disordered breathing: report on 1,249 cases.

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