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Erschienen in: HNO 2/2017

23.01.2017 | Schlafapnoe | Leitthema

Medikamentös induzierte Schlafendoskopie – quo vadis?

Bestandsaufnahme und Ausblick

verfasst von: PD Dr. med. M. Herzog, J. T. Maurer

Erschienen in: HNO | Ausgabe 2/2017

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Zusammenfassung

Hintergrund

Die medikamentös induzierte Schlafendoskopie (MISE) stellt eine Diagnostikmethode dar, mit der die Kollapsneigung der oberen Atemwege durch medikamentös herbeigeführte Sedierung beurteilbar ist. Nach Expertenmeinung ist es dadurch möglich, Lokalisation, Ausmaß und Muster der pharyngolaryngealen Obstruktion während des Schlafs zu imitieren. Dies soll eine zielgerichtetere Therapieempfehlung als bei alleiniger klinischer Untersuchung ermöglichen.

Ziel der Arbeit

Die vorliegende Arbeit evaluiert kritisch den momentanen Stand und Indikationsmöglichkeiten der MISE.

Material und Methoden

Eine PubMed-Literaturrecherche mit den Schlagwörtern „sleep“ und „endoscopy“ oder „DISE“ wurde durchgeführt und relevante Publikationen ausgewertet.

Ergebnisse

Die vorliegende Arbeit bietet einen historischen Abriss über die Literatur und setzt diese in Bezug zu anderen Untersuchungstechniken bei obstruktiver Schlafapnoe. Die aktuelle Entwicklung der MISE in Hinblick auf Medikation, Klassifikationssysteme und Validierung wird evaluiert. Indikationsstellungen für eine MISE werden kritisch beleuchtet und anhand von Literaturdaten diskutiert.

Schlussfolgerung

Die MISE bietet einen tieferen Einblick in die Entstehung von Atemwegsobstruktionen und Schnarchen. Ihre Wertigkeit in Diagnostik und Therapie schlafbezogener Atmungsstörungen (SBAS) konnte zwar bisher nicht pauschal für Nicht-CPAP-Verfahren („continuous positive airway pressure“) nachgewiesen werden, jedoch wurden für einige Therapieverfahren prädiktive Parameter in der MISE definiert. Hierzu zählen z. B. Unterkieferprotrusionsschienen und die atmungssynchrone Stimulation des N. hypoglossus. Damit ist die MISE auch in Zukunft ein wertvolles Diagnostikinstrument bei obstruktiver Schlafapnoe und Schnarchen.
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Metadaten
Titel
Medikamentös induzierte Schlafendoskopie – quo vadis?
Bestandsaufnahme und Ausblick
verfasst von
PD Dr. med. M. Herzog
J. T. Maurer
Publikationsdatum
23.01.2017
Verlag
Springer Medizin
Erschienen in
HNO / Ausgabe 2/2017
Print ISSN: 0017-6192
Elektronische ISSN: 1433-0458
DOI
https://doi.org/10.1007/s00106-016-0329-1

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