Using DISE to evaluate tonsillar obstruction in sleep apnea syndrome in adults.

PURPOSE: Obstructive sleep apnea syndrome is a common condition that can have serious consequences if left untreated. Many patients are intolerant of treatment by continuous positive airway pressure or a mandibular advancement splint. Tonsillopharyngeal surgery may be a viable therapeutic alternative. The objective of this study was to compare clinical assessments of tonsillar obstruction in awake patients with findings from drug-induced sleep endoscopy (DISE). A secondary objective was to evaluate its impact on therapeutic success.

METHODS

A retrospective cohort study was conducted on 270 patients, of whom 128 were selected for the study. Patients were evaluated both clinically and via DISE.

RESULTS

Significant differences were found between tonsillar obstruction pattern observed under sedation with those seen in awake patients. DISE led to the cancellation of surgeries planned in nearly half of the cases. Interestingly, size 2 tonsils, generally considered non-obstructive, were found to be obstructive in 58% of cases. Tonsillectomy and/or pharyngoplasty when performed on patients selected throught DISE was successful in 75% of cases.

CONCLUSION

DISE appears to be a valuable tool for assessing tonsillar obstructions and may allow more patients to benefit from appropriate surgical interventions.