Surgery

Biography

Biography: Alessandro Bucci

Abstract

The aim of this study was to identify patterns of airway collapse and sites of obstruction during drug induced sleep endoscopy (DISE) as predictors of surgical failure following multilevel airway surgery or just somnoplasty for patients with obstructive sleep apnea syndrome (OSAS). A systematic review was performed of studies using DISE to identify sites and patterns of obstruction in patients with OSAS. Medical records of all adult patients undergoing diagnostic DISE at our Centre for Diagnosis and Treatment of Respiratory Sleep Disorders as part of their surgical evaluation were reviewed. For each patient, we recorded obstruction sites, obstruction patterns and the effects of the mandibular pull-up manoeuvre on both obstruction and snoring. We compared the results of clinical and diagnostic evaluation with those of sleep endoscopy. According to other authors, considering a complete obstruction of 100%, we found that palatal obstruction was the most frequently observed site of obstruction, followed by tongue base obstruction, laryngeal obstruction and hypopharyngeal obstruction. DISE is mandatory in the diagnostic work-up of OSA and is a valid addition when surgery is considered. DISE is a dynamic, safe and easy-to-perform technique that visualizes the anatomical sites of snoring or apneas and guides the design of a tailor-made treatment plan in individual cases improving the qualitative and quantitative results of treatment. Understanding the sites of collapse is mandatory for surgical treatment decision-making in obstructive sleep-apneahypopnea syndrome patients. Moreover, it could help prevent unrealistic expectations regarding the available treatment for each patient