0608 Drug-induced Sleep Endoscopy In Obstructive Sleep Apnea-hypopnea Syndrome And Upper Airway Resistance Syndrome. Description And Associations

Abstract

Introduction: Drug-induced sleep endoscopy (DISE) is a good supplementary tool in the diagnostic evaluation of obstructive sleep apnea-hypopnea syndrome (OSAHS) and upper airway resistance syndrome (UARS). Aim of our retrospective study was to describe DISE findings in patients with OSAHS and UARS, and correlate the patterns of upper airway (UA) obstruction with body mass index (BMI) and polysomnography (PSG) findings. Method(s): We retrospectively analyzed all patients who underwent DISE and PSG at our hospital between 01/01/2015 and 12/04/2017. DISE findings were reported using the VOTE classification system. Associations between DISE findings, BMI and PSG pararameters were analyzed. P value was considered statistically significant when p<0,1. Result(s): During the examined period 37 patient (10 female, 27 male) underwent DISE and PSG. Patient characteristics: mean age: 48.2 +/- 12,7 years, mean BMI: 27 +/- 4.4 kg/m2. PSG findings: mean AHI (apnea-hypopnea index): 22.2 +/- 24,2/h, mean ODI (oxygen desaturation index): 27.1 +/- 31/h. Based on PSG, 29.7% of patients were diagnosed with UARS and 21.6 % with mild, 16.2% with moderate and 32.4% with severe OSAHS. Based on DISE, obstruction occured in 83,8% at the level of velum, 75.7% at the level of epiglottis, 73% at the level of tongue base and 43,2% at the level of oropharynx. Multilevel obstruction was observed in 86,5% of patients. The most frequently observed multilevel obstruction pattern was a combination of palatal, tongue base and epiglottis collapse (63.1%). Significant association was found between higher BMI values and the presence of concentric palatal collapse. No significant association was found between AHI/BMI and other levels and patterns of obstruction or multilevel obstruction. Conclusion(s): Our study provides a description of UA obstruction patterns of patients with UARS and OSAHS. Palatal collapse was most frequently observed. Majority of patients had multilevel obstruction with the pattern of palatal, tongue base and epiglottis collapse. Concentric palatal obstruction is significantly associated with increased BMI. The results of this small-scale study help us better understand the pathogenesis of OSA and UARS, and assisting the sleep surgeon in the personalized surgery.