Abstract
Drug-induced sleep endoscopy (DISE) is a diagnostic technique for 3D dynamic anatomical visualisation of upper airway obstruction during sedated sleep. There is a lack of standardised procedure and objective measurement associated with information capture, information management, evaluation of DISE findings, treatment planning, and treatment outcomes. The objective of this study is to present clinical feasibility results using a DISE DATA FUSION system for capturing, merging, displaying and storing anatomical data from an endoscopic imaging system and cardiorespiratory data from an anaesthesiological monitoring system simultaneously in real-time during DISE. This prospective cohort study included 20 patients presenting with symptoms of sleep related breathing disorders undergoing drug-induced sedation endoscopy and had volunteered for DISE DATA FUSION system to be used during their DISE assessment. The DISE DATA FUSION system was used to capture, merge, display, and store anatomical changes from an endoscopic imaging system and cardiorespiratory changes from an anaesthesiological monitoring system simultaneously in real time during drug-induced sedation endoscopy assessment. In all 20 patients, anatomical obstructions at different levels of the pharyngeal lumen (soft palate, velum, tonsils, oropharynx lateral wall, base of tongue, and epiglottis) with a different obstruction configuration and severity were captured simultaneously in real time with its associated cardiorespiratory parameters. Furthermore, a composite video consisting of an anatomical image, blood oxygen level, pulse rate, blood pressure, and timestamp was created for every obstructive event. Our system provides a useful and better way of capturing, merging, visualising, and storing anatomical data/physiological data simultaneously during DISE in real time. Furthermore, it enhances the understanding of the impact of the anatomical severity due to the simultaneous display of the cardiovascular parameters at that specific time of anatomical obstruction for optimising surgical decision based on DISE.
Highlights
Drug-induced sleep endoscopy (DISE), referred to as sleep nasendoscopy (SNE) and first proposed by Croft and Pringle, is a technique for direct visualisation of anatomical site or sites of obstruction in sleeping patients [1]
A bispectral index (BIS) monitor may be used to monitor the depth of sedation during DISE
The key objective of this study is to propose DISE DATA FUSION system, a new clinical technology technique for capturing, merging, displaying and storing upper airway obstruction data from an endoscopic imaging system and its associated cardiorespiratory parameters from an anaesthesiological monitoring system simultaneously in real time during DISE based on image fusion technique
Summary
Drug-induced sleep endoscopy (DISE), referred to as sleep nasendoscopy (SNE) and first proposed by Croft and Pringle, is a technique for direct visualisation of anatomical site or sites of obstruction in sleeping patients [1]. DISE is usually performed in the operating theatre with a patient under anaesthesia. A flexible endoscope is inserted through the nasal cavity, nasopharynx, oropharynx, and above larynx with the purpose of preventing irritation. Additional cardiorespiratory parameters (pulse rate, saturated blood oxygen level and blood pressure) are. A bispectral index (BIS) monitor may be used to monitor the depth of sedation during DISE. DISE is usually carried out by a multi-disciplinary team consisting of an otorhinolaryngologist, anesthesiologist and theatre nurses
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