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Meta-Analysis
. 2017 Dec;21(4):983-994.
doi: 10.1007/s11325-017-1521-6. Epub 2017 Jun 6.

Drug-induced sedation endoscopy (DISE) classification systems: a systematic review and meta-analysis

Esuabom Dijemeni  1   2 , Gabriele D'Amone  3   4 , Israel Gbati  3   5   6
Affiliations
Meta-Analysis

Drug-induced sedation endoscopy (DISE) classification systems: a systematic review and meta-analysis

Esuabom Dijemeni et al. Sleep Breath. 2017 Dec.

Abstract

Purpose: Drug-induced sedation endoscopy (DISE) classification systems have been used to assess anatomical findings on upper airway obstruction, and decide and plan surgical treatments and act as a predictor for surgical treatment outcome for obstructive sleep apnoea management. The first objective is to identify if there is a universally accepted DISE grading and classification system for analysing DISE findings. The second objective is to identify if there is one DISE grading and classification treatment planning framework for deciding appropriate surgical treatment for obstructive sleep apnoea (OSA). The third objective is to identify if there is one DISE grading and classification treatment outcome framework for determining the likelihood of success for a given OSA surgical intervention.

Methods: A systematic review was performed to identify new and significantly modified DISE classification systems: concept, advantages and disadvantages.

Results: Fourteen studies proposing a new DISE classification system and three studies proposing a significantly modified DISE classification were identified. None of the studies were based on randomised control trials.

Conclusion: DISE is an objective method for visualising upper airway obstruction. The classification and assessment of clinical findings based on DISE is highly subjective due to the increasing number of DISE classification systems. Hence, this creates a growing divergence in surgical treatment planning and treatment outcome. Further research on a universally accepted objective DISE assessment is critically needed.

Keywords: Classification; Drug-induced sedation endoscopy; Review; Sleep; Sleep apnea; Upper airway obstruction.

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Conflict of interest statement

Funding

No funding was received for this research.

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This article does not contain any studies with human and animals participants performed by any of the authors.

Figures

Fig. 1
Fig. 1
Flow diagram of study selection
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