Systematic Evaluation of the Sleep Surgery Patient: The Penn Protocol (2023 AMW)
2023 AAO-HNSF Annual Meeting & OTO Experience
Obstructive sleep apnea is increasing in prevalence in the United States and abroad. While CPAP is often the 1st line treatment, greater than 50% of patients have difficulty tolerating it on a consistent basis. Patients often seek care from comprehensive and academic otolaryngologists alike to help manage their obstructive sleep apnea, making this a common presenting complaint within otolaryngology. The etiology of obstructive sleep apnea is often complex, requiring a strong understanding of a patient’s upper airway anatomy and physiology in order to appropriately and successfully manage these patients. In this way, a systematic clinical approach is critical to match therapeutic options to the underlying pathology. In this session, four sleep otolaryngologists will detail the comprehensive, standardized work up and management of the OSA patient through a series of case-based presentations. Careful review of sleep studies with a focus on aspects other than the AHI are crucial in directing clinical management and assisting with patient selection, particularly for hypoglossal nerve stimulation. We will discuss the complete upper airway physical exam with a focus on the skeletal framework, as otolaryngologists often focus their exam on the nasal cavity and soft tissues of the oropharynx, while overlooking the craniofacial skeleton, an increasingly recognized entity in the surgical OSA management. We will also discuss supine endoscopy in the clinic as well as optimizing the drug-induced sleep endoscopy. Finally, we will describe advanced work up including the utility of our standardized CT sleep protocol as well as drug-induced sleep endoscopy with positive airway pressure in patient selection. Through a series of case-based presentations, the audience will learn to recognize exam findings that may impact a patient’s treatment options and most importantly, improve sleep surgery outcomes.
Credits
CME:1.0, MOC:1.0