Narrative review of contemporary treatment options in the care of patients with obstructive sleep apnoea.

Snoring and obstructive sleep apnoea (OSA) are increasingly common conditions, and confer a significant health and socioeconomic burden. Furthermore, untreated OSA represents a significant mortality risk. Patients require careful assessment, including detailed clinical history and examination, sleep study and drug-induced sleep endoscopy (DISE).

European position paper on drug-induced sedation endoscopy (DISE).

Background: Although drug-induced sedation endoscopy (DISE) represents the most widespread diagnostic tool for upper airway endoscopic evaluation of snoring and obstructive sleep apnea hypopnea syndrome (OSAHS), many controversies exist about how to perform the sedation, the indications for DISE, and how to report DISE findings. The present position paper reports on a consensus as proposed by a group of European experts in the field of DISE after discussion during a recent dedicated meeting.

Methods: The authors have evaluated all the available evidence reported in the literature and have compared experience among various departments in leading European centers in order to provide a standardization of the DISE procedure and an in-depth insight in the main aspects of this technique.

Role of surgery in adult obstructive sleep apnoea.

A surgical approach to treatment of obstructive sleep apnoea (OSA) remains an area of intense debate, both within and without the surgical community itself. Continuous positive airway pressure (CPAP) therapy remains the gold standard for the treatment of OSA, however surgery may be indicated to facilitate CPAP and/or improve compliance in cases where CPAP is poorly tolerated. This article summarises the current range of surgical treatment options together with the evidence base for their intervention in otolaryngology, maxillofacial and bariatric surgery.

Observer variation in drug-induced sleep endoscopy: experienced versus nonexperienced ear, nose, and throat surgeons.

Study Objective: To determine variations in interobserver and intraobserver agreement of drug-induced sleep endoscopy (DISE) in a cohort of experienced versus nonexperienced ear, nose, and throat (ENT) surgeons.

Design: Prospective, blinded agreement study.

Setting: Ninety-seven ENT surgeons (90 nonexperienced with DISE; seven experienced) observed six different DISE videos and were asked to score the upper airway (UA) level (palate, oropharynx, tongue base, hypopharynx, epiglottis), direction (anteroposterior, concentric, lateral), and degree of collapse (none; partial or complete collapse).

Is sleep nasendoscopy a valuable adjunct to clinical examination in the evaluation of upper airway obstruction?

The objective of the study is to assess the correlation between outpatient department (OPD) assessment and sleep nasendoscopy (SNE) in treatment planning for sleep related breathing disorders. The study design includes a blinded, cohort study comparing the treatment prediction based on OPD clinical evaluation with SNE in consecutive, adult patients by a single clinician with a specialist interest in snoring related disorders. Patients with moderate to severe obstructive sleep apnoea and those who had undergone previous treatment were excluded.

Sleep nasendoscopy: a 10-year retrospective audit study.

Sleep nasendoscopy was conceived at the Royal National Throat, Nose and Ear Hospital, UK in 1991, and has remained fully implemented in patient selection for targeted treatment of the spectrum of sleep-disordered breathing. The senior authors (B.T.

Sleep nasendoscopy: a diagnostic tool for predicting treatment success with mandibular advancement splints in obstructive sleep apnoea.

This prospective, cohort study evaluated the role of sleep nasendoscopy (SNE) with simultaneous mandibular protrusion in predicting successful mandibular advancement splint (MAS) therapy in subjects with obstructive sleep apnoea (OSA). Nineteen OSA subjects diagnosed by overnight polysomnography were referred for MAS therapy, following SNE investigation. A Herbst MAS was fabricated for each subject.