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Clinical Trial
. 2020 Feb;130(2):551-555.
doi: 10.1002/lary.27987. Epub 2019 Apr 17.

Does drug-induced sleep endoscopy affect surgical outcome? A multicenter study of 326 obstructive sleep apnea patients

Kenny P Pang  1 , Peter M Baptista  2 , Ewa Olszewska  3 , Itzhak Braverman  4 , Marina Carrasco-Llatas  5 , Srivinas Kishore  6 , Sudipta Chandra  7 , Hyung Chae Yang  8 , Cybil Mei Zhi Wang  1 , Yiong Huak Chan  9 , Kathleen A Pang  1 , Edward B Pang  10 , Brian Rotenberg  11
Affiliations
Clinical Trial

Does drug-induced sleep endoscopy affect surgical outcome? A multicenter study of 326 obstructive sleep apnea patients

Kenny P Pang et al. Laryngoscope. 2020 Feb.

Abstract

Objectives/hypothesis: Our objective was to determine whether drug-induced sleep apnea (DISE) affects the successfulness of the surgical outcome.

Study design: Prospective, seven-country, nonrandomized trial.

Methods: There were 326 consecutive obstructive sleep apnea (OSA) patients who had nose, palate, and/or tongue surgery included in the study. DISE was performed in only one group.

Results: There were 170 patients in the DISE group and 156 patients in no-DISE group. The mean preoperative body mass index (BMI) for the DISE group was 27.6 ± 4.6, whereas in the no-DISE group it was 28.1 ± 3.9 (P = .23). The mean preoperative systolic blood pressure (SBP) for the DISE group was 130.4 ± 16.7, whereas in the no-DISE group it was 142.9 ± 15.5 (P < .001). The mean preoperative diastolic blood pressure (DBP) for the DISE group was 81.4 ± 9.7, whereas in the no-DISE group it was 89.1 ± 9.7 (P < .001). The mean preoperative apnea-hypopnea index (AHI) for the DISE group was 32.6 ± 18.8, whereas in the no-DISE group it was 33.7 ± 19.6 (P = .61). The mean postoperative AHI for the DISE group was 15.9 ± 12.6, whereas in the no-DISE group it was 13.2 ± 8.8 (P = .023). The age-, gender-, BMI-adjusted percentage change in AHI for the DISE group was -48.4 ± 31.9, whereas in the no-DISE group it was -59.8 ± 18.6 (P < .001). The age-, gender-, and BMI-adjusted success rate for the DISE group was 66.5%, whereas in the no-DISE group it was 80.8% (P = .004). The age-, gender-, and BMI-adjusted change in SBP for the DISE group was -6.1 ± 8.6, whereas in the no-DISE group it was -13.3 ± 11.1 (P < .001). The age-, gender-, and BMI-adjusted change in DBP in the DISE group was -5.2 ± 12.1, whereas in the no-DISE group it was -12.4 ± 11.7 (P < .001). The mean age- and gender-adjusted change in BMI for the DISE group was -4.6 ± 12.9, whereas in the no-DISE group it was -6.3 ± 18.5 (P = .34). The Cohen effect of BMI on the overall AHI, lowest oxygen saturation, and blood pressure changes was 0.08.

Conclusions: DISE may not significantly affect surgical success in OSA.

Level of evidence: 2c Laryngoscope, 130:551-555, 2020.

Keywords: Drug-induced sleep endoscopy; obstructive sleep apnea; success rate.

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References

BIBLIOGRAPHY

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