Endoscopic surgery.
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The value of drug-induced sleep endoscopy (DISE) is a topic that continues to be debated in otolaryngology, and experts took sides in a panel session held during the Triological Society Combined Sections Meeting, shedding light on the advantages and disadvantages of the procedure, as well as its efficacy in children with obstructive sleep apnea (OSA).
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March 2017Detecting Obstruction
Jolie Chang, MD, assistant professor in the department of otolaryngology-head and neck surgery at the University of California San Francisco, said DISE, which involves a three-dimensional assessment of the airway during sedation that’s intended to mimic what happens during sleep, can be an asset in several ways. “It’s especially useful as a procedure for assessing the upper airway to determine surgical planning, candidacy for the hypoglossal nerve implant, and for surgical non-responders,” she said.
In comparisons with in-office awake exams, DISE has been found to be better at detecting more severe obstruction in OSA, particularly at the hypopharynx, and can pick up epiglottis obstruction that might not be seen in patients who are awake (Laryngoscope. 2013;123:2315-2318).