A Critical Analysis of Pharyngeal Patterns of Collapse in Obstructive Sleep Apnea: Beyond the Endoscopic Classification Systems.
Andrea De VitoEwa OlszewskaBhik KotechaEric R ThulerManuele CasaleGiovanni CammarotoClaudio ViciniOlivier M VandervekenPublished in: Journal of clinical medicine (2023)
(1) Background: Drug-Induced Sleep Endoscopy (DISE) enables the three-dimensional and dynamic visualization of the upper airway (UA) during sleep, which is useful in selecting the best treatment option for obstructive sleep apnea (OSA) patients, particularly for surgical procedures. Despite international consensus statements or position papers, a universally accepted DISE methodology and classification system remain a controversial open question. (2) Methods: A review of the English scientific literature on DISE related to endoscopic classification systems and surgical outcome predictors (3) Results: Of the 105 articles, 47 were included in the analysis based on their content's relevance to the searched keywords. (4) Conclusions: A final report and scoring classification system is not universally accepted; the most internationally applied endoscopic classification system during DISE does not cover all patterns of events that occur simultaneously during the endoscopic examination, highlighting that several configurations of collapse and obstruction at different UA levels could be observed during DISE, which should be described in detail if DISE has to be considered in the decision-making process for the UA surgical treatment in OSA patients and if DISE has to have a role as a predictive factor for surgical outcomes analysis.
Keyphrases
- obstructive sleep apnea
- end stage renal disease
- drug induced
- ultrasound guided
- ejection fraction
- positive airway pressure
- newly diagnosed
- chronic kidney disease
- liver injury
- machine learning
- deep learning
- physical activity
- peritoneal dialysis
- prognostic factors
- systematic review
- patient reported outcomes
- depressive symptoms
- sleep apnea