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20.11.2021 | Sleep Breathing Physiology and Disorders • Original Article

Effectiveness of drug-induced sleep endoscopy in improving outcomes of barbed pharyngoplasty for obstructive sleep apnea surgery: a prospective randomized trial

verfasst von: Giannicola Iannella, Giuseppe Magliulo, Giovanni Cammaroto, Giuseppe Meccariello, Andrea De Vito, Stefano Pelucchi, Andrea Ciorba, Antonino Maniaci, Salvatore Cocuzza, Giampiero Gulotta, Annalisa Pace, Ruggero Massimo Corso, Ahmed Bahgat, Claudio Vicini

Erschienen in: Sleep and Breathing | Ausgabe 4/2022

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Abstract

Purpose

To observe the effectiveness of preoperative drug-induced sleep endoscopy in improving surgical results of patients undergoing single-level barbed pharyngoplasty surgery for OSA, using a prospective randomized model.

Methods

A single-center randomized controlled trial with two prospective arms was carried out to compare functional results in patients treated with barbed reposition pharyngoplasty (BRP) surgery without a preoperative drug-induced sleep endoscopy (DISE) evaluation vs patients treated with BRP surgery performed after DISE evaluation of sites/patterns of collapse.

Results

We compared 50 patients who underwent BRP without a preoperative DISE evaluation (Group A) and 42 patients (Group B) treated with BRP surgery but preoperatively selected by means of a preoperative DISE. In this second group of patients, after DISE evaluation, 70% of patients were selected for single-level BRP surgery because they showed an isolated velopharyngeal collapse at the DISE evaluation, without obstruction at other upper airway levels evaluated. Both groups of patients showed a statistically significant difference between preoperative and postoperative values of AHI, ODI, and LOS (p<0.05 in all cases). Comparing Group A and Group B patients, the therapeutic success rate was found to be 60% in patients treated without preoperative DISE evaluation and 83% in patients treated with preoperative DISE (p = 0.02).

Conclusion

DISE appears to improve the surgical results of single-level velopharyngeal surgery due to the possibility of excluding patients with obstruction of the base of the tongue, the hypopharynx, and the epiglottis/larynx.

Montevecchi F, Meccariello G, Firinu E et al (2018) Prospective multicentre study on barbed reposition pharyngoplasty standing alone or as a part of multilevel surgery for sleep apnoea. Clin Otolaryngol 43:483–488 PubMedCrossRef

Magliulo G, Iannella G, Ciofalo A et al (2019) Nasal pathologies in patients with obstructive sleep apnoea. Acta Otorhinolaryngol Ital 39:250–256 PubMedPubMedCentralCrossRef

Li HY (2019) Palatal surgery for obstructive sleep apnea: from ablation to reconstruction. Sleep Med Clin 14:51–58 PubMedCrossRef

Pang KP, Woodson BT (2007) Expansion sphincter pharyngoplasty: a new technique for the treatment of obstructive sleep apnea. Otolaryngol Head Neck Surg 137:110–114 PubMedCrossRef

Iannella G, Vallicelli B, Magliulo G et al (2020) Long-term subjective outcomes of barbed reposition pharyngoplasty for obstructive sleep apnea syndrome treatment. Int J Environ Res Public Health 17:1542 PubMedCentralCrossRef

Cammaroto G, Stringa LM, Iannella G et al (2020) Manipulation of lateral pharyngeal wall muscles in sleep surgery: a review of the literature. Int J Environ Res Public Health 17:5315 PubMedCentralCrossRef

Camacho M, Zaghi S, Piccin O, Certal V (2016) Expansion sphincter pharyngoplasty for obstructive sleep apnea: an update to the recent meta-analysis. Eur Arch Otorhinolaryngol 273:2857–2858 PubMedCrossRef

Peng BG, Lai YQ, Lei HJ, Zhang N, Wang X (2019) Strategies in the clinical diagnosis and surgical treatment of OSAHS with multilevel obstruction. J Int Med Res 47:1533–1543 PubMedPubMedCentralCrossRef

Coughlin K, Davies GM, Gillespie MB (2020) Phenotypes of obstructive sleep apnea. Otolaryngol Clin North Am 53:329–338 PubMedCrossRef

10.

Magliulo G, De Vincentiis M, Iannella G et al (2018) Olfactory evaluation in obstructive sleep apnoea patients. Acta Otorhinolaryngol Ital 38:338–345 PubMedPubMedCentralCrossRef

11.

Albdah AA, Alkusayer MM, Al-Kadi M, Almofada H, Alnofal EA, Almutairi S (2019) The impact of drug-induced sleep endoscopy on therapeutic decisions in obstructive sleep apnea: a systematic review and meta-analysis. Cureus 11:6041

12.

Iannella G, Vicini C, Colizza A et al (2019) Aging effect on sleepiness and apneas severity in patients with obstructive sleep apnea syndrome: a meta-analysis study. Eur Arch Otorhinolaryngol 276:3549–3556 PubMedCrossRef

13.

Yegïn Y, Çelik M, Kaya KH, Koç AK, Kayhan FT (2017) Comparison of drug-induced sleep endoscopy and Müller’s maneuver in diagnosing obstructive sleep apnea using the VOTE classification system. Braz J Otorhinolaryngol 83:445–450 PubMedCrossRef

14.

Wang WM, Hsu YB, Lan MY, Yang MC, Huang TT, Liu CJ, Lan MC (2018) The relationship between modified Mallampati score, Müller’s maneuver and drug-induced sleep endoscopy regarding retrolingual obstruction. Ann Otol Rhinol Laryngol 127:463–469 PubMedCrossRef

15.

Soares D, Folbe AJ, Yoo G, Badr MS, Rowley JA, Lin HS (2013) Drug-induced sleep endoscopy vs awake Müller’s maneuver in the diagnosis of severe upper airway obstruction. Otolaryngol Head Neck Surg 148:151–156 PubMedCrossRef

16.

Carrasco-Llatas M, Martínez-Ruiz de Apodaca P, Vaz de Castro J, Matarredona-Quiles S, Dalmau-Galofre J (2019) Drug-induced sleep endoscopy as a tool for surgical planning. Curr Otorhinolaryngol Rep [Internet] 7:1–9 CrossRef

17.

Vicini C, De Vito A, Iannella G et al (2018) The aging effect on upper airways collapse of patients with obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 275:2983–2990 PubMedCrossRef

18.

Bharathi MB, Rajendra Prasad J, Satish K (2017) Drug-induced sleep endoscopy as a selection tool for surgical management of obstructive sleep apnoea syndrome: our personal experience. Indian J Otolaryngol Head Neck Surg. 69:313–318 PubMedPubMedCentralCrossRef

19.

De Vito A, Carrasco Llatas M et al (2018) European position paper on drug-induced sleep endoscopy: 2017 Update. Clin Otolaryngol 43:1541–1552 PubMedCrossRef

20.

Cambi J, Chiri ZM, De Santis S, Franci E, Frusoni F, Ciabatti PG, Boccuzzi S (2019) Outcomes in single-stage multilevel surgery for obstructive sleep apnea: transoral robotic surgery, expansion sphincter pharyngoplasty and septoplasty. Int J Med Robot 15:2034 CrossRef

21.

Pinto JA, Godoy LBM, Nunes HDSS et al (2020) Lateral-expansion pharyngoplasty: combined technique for the treatment of obstructive sleep apnea syndrome. Int Arch Otorhinolaryngol 24:107–111 CrossRef

22.

Madkikar N, Pandey S, Ghaisas V (2019) Multi level single stage: barbed reposition pharyngoplasty and nasal surgery in treatment of OSA-our experience. Indian J Otolaryngol Head Neck Surg 71:309–314 PubMedPubMedCentralCrossRef

23.

Dachuri S, Sachidananda R, Montevecchi F et al (2019) Barbed reposition pharyngoplasty in Indian population: a new palatal surgery for OSAS. Indian J Otolaryngol Head Neck Surg. 71:249–253 PubMedCrossRef

24.

Bosco G, Pérez-Martín N, Racionero MA, Plaza G (2019) Expansion sphincter pharyngoplasty: usefulness of DISE. Faringoplastia de expansión: utilidad de la somnoscopia (DISE). Acta Otorrinolaringol Esp 70:215–221 CrossRef

25.

Friberg D, Sundman J, Browaldh N (2020) Long-term evaluation of satisfaction and side effects after modified uvulopalatopharyngoplasty. Laryngoscope 130:263–268 PubMedCrossRef

26.

Lorusso F, Dispenza F, Modica DM, Gallina S (2018) The role of modified expansion sphincter pharyngoplasty in multilevel obstructive sleep apnea syndrome surgery. Int Arch Otorhinolaryngol 22:432–436 PubMedPubMedCentralCrossRef

27.

Minni A, Cialente F, Ralli M, et al. (2020) Uvulopalatopharyngoplasty and barbed reposition pharyngoplasty with and without hyoid suspension for obstructive sleep apnea hypopnea syndrome: a comparison of long-term functional results. Bosn J Basic Med Sci. 27

28.

Friedman M, Ibrahim H, Bass L (2002) Clinical staging for sleep-disordered breathing. Otolaryngol Head Neck Surg 127:13–21 PubMedCrossRef

29.

Elshaug AG, Moss JR, Southcott AM, Hiller JE (2007) Redefining success in airway surgery for obstructive sleep apnea: a meta analysis and synthesis of the evidence. Sleep 30:461–467 PubMedCrossRef

30.

Vicini C, Hendawy E, Campanini A et al (2015) Barbed reposition pharyngoplasty (BRP) for OSAHS: a feasibility, safety, efficacy and teachability pilot study. “We are on the giant’s shoulders.” Eur Arch Otorhinolaryngol 272:3065–3070 PubMedCrossRef

31.

Pang KP, Baptista PM, Olszewska E, Braverman I, Carrasco-Llatas M, Kishore S, Chandra S, Yang HC, Wang CMZ, Chan YH, Pang KA, Pang EB, Rotenberg B (2020) Does drug-induced sleep endoscopy affect surgical outcome? A multicenter study of 326 obstructive sleep apnea patients. Laryngoscope 130:551–555 PubMedCrossRef

32.

Fernández-Julián E, García-Pérez MÁ, García-Callejo J, Ferrer F, Martí F, Marco J (2014) Surgical planning after sleep versus awake techniques in patients with obstructive sleep apnea. Laryngoscope 124:1970–1974 PubMedCrossRef

33.

Green KK, Kent DT, D’Agostino MA et al (2019) Drug-induced sleep endoscopy and surgical outcomes: a multicenter cohort study. Laryngoscope 129:761–770 PubMedCrossRef

34.

Aktas O, Erdur O, Cirik AA, Kayhan FT (2015) The role of drug-induced sleep endoscopy in surgical planning for obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 272:2039–2043 PubMedCrossRef

35.

Huntley C, Chou D, Doghramji K, Boon M (2017) Preoperative drug induced sleep endoscopy improves the surgical approach to treatment of obstructive sleep apnea. Ann Otol Rhinol Laryngol 126:478–482 PubMedCrossRef

36.

Gillespie MB, Reddy RP, White DR, Discolo CM, Overdyk FJ, Nguyen SA (2013) A trial of drug-induced sleep endoscopy in the surgical management of sleep-disordered breathing. Laryngoscope 123:277–282 PubMedCrossRef

37.

Blumen MB, Latournerie V, Bequignon E, Guillere L, Chabolle F (2015) Are the obstruction sites visualized on drug-induced sleep endoscopy reliable? Sleep Breath. 19:1021–1026 PubMedCrossRef

38.

Baudouin R, Alali A, Hans S, Blumen M, Chabolle F (2020) OSAS and upper pharynx surgery: does basilingual collapsus always rhyme with failure? Eur Ann Otorhinolaryngol Head Neck Dis 3:1879–7296

39.

Hsu YS, Jacobowitz O (2017) Does sleep endoscopy staging pattern correlate with outcome of advanced palatopharyngoplasty for moderate to severe obstructive sleep apnea? J Clin Sleep Med 13:1137–1144 PubMedPubMedCentralCrossRef

40.

Certal VF, Pratas R, Guimarães L, Lugo R, Tsou Y, Camacho M, Capasso R (2016) Awake examination versus DISE for surgical decision making in patients with OSA: a systematic review. Laryngoscope 126:768–774 PubMedCrossRef

41.

Pang KP, Plaza G, Baptista JPM et al (2018) Palate surgery for obstructive sleep apnea: a 17-year meta-analysis. Eur Arch Otorhinolaryngol 275:1697–1707 PubMedCrossRef

42.

Berry RB, Budhiraja R, Gottlieb DJ et al (2012) (2007) Rules for scoring respiratory events in sleep: update of the AASM Manual for the scoring of sleep and associated events. J Clin Sleep Med 8:597–619 PubMedPubMedCentralCrossRef

43.

Kezirian EJ, Hohenhorst W, de Vries N (2011) Drug-induced sleep endoscopy: the VOTE classification. Eur Arch Otorhinolaryngol 268:1233–1236 PubMedCrossRef

44.

Hessel NS, de Vries N (2003) Results of uvulopalatopharyngoplasty after diagnostic workup with polysomnography and sleep endoscopy: a report of 136 snoring patients. Eur Arch Otorhinolaryngol 260:91–95 PubMedCrossRef

Titel: Effectiveness of drug-induced sleep endoscopy in improving outcomes of barbed pharyngoplasty for obstructive sleep apnea surgery: a prospective randomized trial
verfasst von: Giannicola Iannella
Giuseppe Magliulo
Giovanni Cammaroto
Giuseppe Meccariello
Andrea De Vito
Stefano Pelucchi
Andrea Ciorba
Antonino Maniaci
Salvatore Cocuzza
Giampiero Gulotta
Annalisa Pace
Ruggero Massimo Corso
Ahmed Bahgat
Claudio Vicini
Publikationsdatum: 20.11.2021
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 4/2022
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-021-02528-4

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Effectiveness of drug-induced sleep endoscopy in improving outcomes of barbed pharyngoplasty for obstructive sleep apnea surgery: a prospective randomized trial

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