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Change of obstruction level during drug‐induced sleep endoscopy according to sedation depth in obstructive sleep apnea
Author(s) -
Hong Sang Duk,
Dhong HunJong,
Kim Hyo Yeol,
Sohn Jung Hyeob,
Jung Yong Gi,
Chung SeungKyu,
Park Ju Yeon,
Kim Jin Kyoung
Publication year - 2013
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24045
Subject(s) - sedation , medicine , airway , anesthesia , airway obstruction , obstructive sleep apnea , breathing , bispectral index , sleep apnea , endoscopy , surgery
Objectives/Hypothesis We evaluated the change in upper airway collapse according to the depth of sedation during drug‐induced sleep endoscopy (DISE), as well as characteristics possibly associated with that change. Study Design Prospective, single center, observational study. Methods Twenty‐nine patients with upper airway collapse were twice evaluated using DISE according to the depth of sedation, as confirmed by the bispectral index (BIS), which is a measure of the level of consciousness. Changes in the site and degree of obstruction according to the change in sedation depth at the retropalatal and the retroglossal levels were evaluated. The possible contributing factors of this change were explored. Results As DISE sedation deepened, the upper airway became narrower in 37% of patients at the retropalatal level and in 44.8% of patients at the retroglossal level. No clinical, polysomnographic, or cephalometric variables showed any association with the change in the degree of retroglossal airway narrowing, with the exception of mouth breathing during DISE. Conclusions The degree of upper airway narrowing can be aggravated according to the sedation depth. The monitoring of sedation depth during DISE is critical, especially in patients with mouth breathing. Level of Evidence 4. Laryngoscope , 123:2896–2899, 2013