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Comparative Study
. 2010 Apr;30(2):73-7.

Awake versus sleep endoscopy: personal experience in 250 OSAHS patients

A Campanini  1 , P Canzi, A De Vito, I Dallan, F Montevecchi, C Vicini
Affiliations
Comparative Study

Awake versus sleep endoscopy: personal experience in 250 OSAHS patients

A Campanini et al. Acta Otorhinolaryngol Ital. 2010 Apr.

Abstract
in English, Italian

Identifying the site of obstruction and the pattern of airway change during sleep are the key points essential to guide surgical treatment decision making for Obstructive Sleep Apnoea-Hypopnoea Syndrome in adults. In this investigation, 250 cases were retrospectively analyzed in order to compare the pharyngolaryngeal endoscopic findings detected in the awake state, with those obtained in drug-induced sedation, by means of the Sleep Endoscopy technique. All endoscopic findings have been classified according to the semi-quantitative NOH staging. The awake and sedation NOH resulted identical in 25% of the cases only, while the discrepancies involved the oropharyngeal and hypopharyngeal sites, respectively in about 33% and 50% of the patients. The laryngeal obstructive role detected during sedation in almost 33% of the cases was both unforeseen and relevant, with all the consequent implications in the treatment choices particularly for the surgical cases.

Punti chiave essenziali per definire la programmazione chirurgica nell’adulto affetto da Sindrome delle Apnee-Ipopnee Ostruttive del Sonno sono l’identificazione del sito e del pattern di ostruzione che avvengono durante il sonno. Abbiamo analizzato retrospettivamente 250 casi allo scopo di confrontare i rilievi endoscopici faringolaringei ottenuti in veglia con quelli osservati in sedazione farmaco-indotta (Sleep Endoscopy). Ciascun riscontro endoscopico è stato classificato secondo il sistema semi-quantitativo NOH. Solamente nel 25% dei casi l’NOH in veglia ed in sedazione sono risultati identici, mentre le divergenze hanno riguardato i siti orofaringeo ed ipofaringeo rispettivamente nel 33% ed in circa il 50% dei pazienti. Imprevisto e rilevante il ruolo ostruttivo laringeo emerso durante la sedazione in quasi un terzo dei casi, con tutte le conseguenti implicazioni nelle scelte terapeutiche soprattutto se chirurgiche.

Keywords: OSAHS; Sleep endoscopy; Snoring.

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Figures

Fig. 1
Fig. 1
NOH Mismatch – discrepancy rates on Oropharyngeal (O) and Hypopharyngeal (H) findings.
Fig. 2
Fig. 2
Laryngeal involvement during sedation – obstruction frameworks.
See this image and copyright information in PMC

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