Drug-Induced Sleep Endoscopy in Obstructive Sleep Apnea, Part 1 (2023 AMW) Session
2023 AAO-HNSF Annual Meeting & OTO Experience
PROGRAM DESCRIPTION: A goal of obstructive sleep apnea surgical evaluation is the identification of the pattern of upper airway obstruction. By addressing airway obstruction in a targeted fashion, it may be possible to tailor surgical treatment to a patient's specific pattern of obstruction--improving surgical results and/or minimizing the scope of surgical intervention. Compared to other commonly-used evaluation techniques, drug-induced sleep endoscopy (DISE) has the unique advantage of providing a dynamic assessment under sleep-like conditions to evaluate the structures contributing to airway obstruction. Part 1 of this 2-hour program will include a detailed discussion of the VOTE Classification that the panelists developed. DISE evaluation is aided by a number of specific passive maneuvers, including various mandible, head, and body positions. Technical pearls based on the panelists' experience with more than 10,000 DISE procedures will be presented, along with example videos of typical and unique pathologic findings. The strengths and limitations of DISE will be discussed, based on a literature review and presentation of research findings. Part 2 will incorporate an interactive discussion based on sample DISE videos, allowing attendees to develop a comfort level with characterizing DISE findings using the VOTE Classification. This will incorporate a discussion of the use of DISE in hypoglossal nerve stimulation treatment selection as well as DISE during CPAP administration.OUTCOME OBJECTIVE 1: Use the VOTE Classification to characterize DISE findings and understand their implications.OUTCOME OBJECTIVE 2: Understand how DISE can improve the selection of surgical procedures and oral appliances in the treatment of OSA.OUTCOME OBJECTIVE 3: Initiate DISE program or consider DISE technique modifications in your practiceBACKGROUND STATEMENT: Compared to other techniques of upper airway evaluation in obstructive sleep apnea, drug-induced sleep endoscopy uniquely offers a dynamic assessment in sedated patients. This assessment is adopted widely because of its role in screening potential hypoglossal nerve stimulation candidates