• Madeline J L Ravesloot and Nico de Vries.
• Department of Otolaryngology-Head and Neck Surgery, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands. m.ravesloot@slaz.nl
• Laryngoscope. 2011 Dec 1;121(12):2710-6.

Objectives/HypothesisPolysomnography (PSG) is mandatory in the diagnostic workup of obstructive sleep apnea (OSA); drug-induced sleep endoscopy (DISE) is a valid addition. DISE is a dynamic, safe, easy-to-perform technique that visualizes the anatomic sites of snoring or apneas and guides the making of a tailor-made treatment plan in individual cases. The aim of this prospective study was to document the results of 100 consecutive DISE procedures and investigate associations between PSG and DISE findings.Study DesignThis prospective, single-center, observational study enrolled 100 consecutive patients between June and August 2010.MethodsAll 100 patients eligible for sleep surgery or a mandibular repositioning appliance (MRA) underwent PSG and DISE (using midazolam or propofol). DISE findings were reported using the VOTE classification system; site, degree of airway narrowing, and configuration of obstruction were reported. Associations were analyzed between PSG results, patient characteristics, and DISE findings.ResultsOur results suggest that a multilevel collapse, a complete collapse, and a tongue-base collapse are statistically significantly associated with higher apnea hypopnea index values. A tongue base collapse or epiglottal collapse is associated with positional OSA. Complete concentric collapse is statistically significantly associated with an increased body mass index.ConclusionsThe results of this small-scale study help us understand the pathogenesis of OSA and the various associations between PSG outcomes and DISE results, as well as assisting the sleep surgeon in tailoring surgery for the patient.Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

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