Troubleshooting Upper Airway Stimulation Therapy Using Drug-Induced Sleep Endoscopy
Recommended Citation
Kaffenberger TM, Plawecki A, Kaki P, Boon M, and Huntley C. Troubleshooting Upper Airway Stimulation Therapy Using Drug-Induced Sleep Endoscopy. Otolaryngol Head Neck Surg 2024.
Document Type
Article
Publication Date
4-21-2024
Publication Title
Otolaryngology and head and neck surgery
Abstract
OBJECTIVE: This study assesses the utility of drug-induced sleep endoscopy (DISE) in guiding further treatment for patients with obstructive sleep apnea (OSA) who have difficulty tolerating upper airway stimulation (UAS) or have inadequate response to therapy.
STUDY DESIGN: We conducted a retrospective analysis of UAS patients at our institution who underwent DISE, post-UAS, and evaluated the efficacy of different electrode configurations and maneuvers.
SETTING: A tertiary care hospital.
METHODS: Out of 379 patients who received UAS therapy, 34 patients who underwent DISE post-UAS (DISE-UAS) were included. Palatal coupling (PC) was assessed with UAS stimulation alone, jaw thrust alone, and both simultaneously during DISE.
RESULTS: Among 34 patients, 5 had suboptimal adherence to UAS therapy, 19 had suboptimal therapy efficacy with residual OSA burden, and 10 had both. During DISE-UAS, PC was observed in 7 patients (21%) with UAS stimulation alone, 9 patients (26%) with jaw thrust alone, and 8 patients (24%) with both maneuvers combined. Notably, 10 patients (29%) did not exhibit PC with any maneuver. Based on DISE-UAS findings, 13 patients were recommended oral appliance therapy (OAT), and 8 patients underwent further surgical interventions.
CONCLUSION: DISE-UAS is a valuable adjunct in troubleshooting UAS therapy for patients intolerant to CPAP or with suboptimal therapy efficacy. This study provides an algorithm for targeted multimodality therapy based on DISE findings, facilitating personalized management approaches.
PubMed ID
38643409
ePublication
ePub ahead of print
