Clinical Analysis of Drug‐Induced Sleep Endoscopy for the OSA Patient

Abstract

Objectives: Determine if performing drug-induced sleep endoscopy (DISE) and trans-oral robotic surgery (TORS) for the treatment of obstructive sleep apnea (OSA) is associated with improved outcomes and acceptable complication rates when compared to traditional surgical procedures without DISE. Methods: A retrospective, nonrandomized chart review. Patients with OSA who underwent uvulopalatopharyngoplasty (UPPP) in 2011 were compared with a prospective, nonrandomized group of patients with OSA who underwent DISE with other indicated procedures from 2012-2013 at a major tertiary care center. The pre- and postoperative apnea-hypopnea index (AHI), pre- and postoperative Epworth Sleepiness Scale (ESS), and major complication rate were compared. Results: Forty patients underwent UPPP without DISE. These patients showed a significant reduction in AHI –20.1 ( P = .001) and a complication rate of 3% ( P = .001). There was no significant change in ESS –2.2 ( P = .734). Fifty-nine patients underwent DISE with other indicated procedures. These patients showed a significant reduction in AHI –21.4 ( P = .001) and a complication rate of 34.7% ( P = .001). There was no significant difference in ESS +0.1 ( P = .734) or AHI ( P = .092) between the 2 groups. Conclusions: There was no significant difference in AHI or ESS in patients who underwent UPPP without DISE compared to patients who underwent DISE with other indicated procedures including TORS. Patients who had DISE and TORS surgical interventions for OSA demonstrated an increase in the rate of major complications.