Effect of Drug-Induced Sedation Endoscopy on the Decision of Treatment Plan in Patients with Obstructive Sleep Apnea
Korean Journal of Otorhinolaryngology-head and Neck Surgery(2018)
Abstract
Background and Objectives Drug-induced sedation endoscopy (DISE) has recently gained popularity among otolaryngologists because it can provide direct information of upper airway obstruction in patients with obstructive sleep apnea (OSA). In that regard, we examined how DISE examination affected the decision of clinicianâs treatment plan and the consequent patientâs compliance in OSA patients. Subjects and Method All enrolled patients were classified into two groups according to the method of upper airway evaluation employed: a physical examination only group and a physical examination combined with DISE group. The clinicianâs treatment plan was categorized into the following four groups: sleep surgery, positive airway pressure, oral appliance, and sleep surgery combined with oral appliance. The change of patientâs compliance was also evaluated. Results There were several differences in how DISE evaluation affected the decision of clinicianâs treatment plan and patientâs compliance between the two groups. The rate for sleep surgery fell from 69.6% to 15.9%; on the other hand, the rate for positive airway pressure, oral appliance and sleep surgery combined with oral appliance all increased from 13.0% to 36.2%, 14.5% to 26.6%, and 2.9% to 21.3%, respectively. The patientâs compliance also changed after DISE evaluation: sleep surgery, positive airway pressure, oral appliance and sleep surgery combined with oral appliance all increased from 78.1% to 87.9%, 16.7% to 76.0%, 25.0% to 87.3%, and 50.0% to 91.03%, respectively. Conclusion We found that DISE examination influences the decision of clinicianâs treatment plan and patientâs compliance. We suggest additional cohort studies to confirm these findings. Key words: Endoscopy ã Obstructive sleep apnea ã Oral appliance ã Positive airway pressure ã Surgery
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Key words
obstructive sleep apnea,endoscopy,treatment plan,drug-induced
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