Purpose: To observe the effectiveness of preoperative drug-induced sleep endoscopy in improving surgical results of patients undergoing single-level barbed pharyngoplasty surgery for OSA, using a prospective randomized model. Methods: A single-center randomized controlled trial with two prospective arms was carried out to compare functional results in patients treated with barbed reposition pharyngoplasty (BRP) surgery without a preoperative drug-induced sleep endoscopy (DISE) evaluation vs patients treated with BRP surgery performed after DISE evaluation of sites/patterns of collapse. Results: We compared 50 patients who underwent BRP without a preoperative DISE evaluation (Group A) and 42 patients (Group B) treated with BRP surgery but preoperatively selected by means of a preoperative DISE. In this second group of patients, after DISE evaluation, 70% of patients were selected for single-level BRP surgery because they showed an isolated velopharyngeal collapse at the DISE evaluation, without obstruction at other upper airway levels evaluated. Both groups of patients showed a statistically significant difference between preoperative and postoperative values of AHI, ODI, and LOS (p<0.05 in all cases). Comparing Group A and Group B patients, the therapeutic success rate was found to be 60% in patients treated without preoperative DISE evaluation and 83% in patients treated with preoperative DISE (p = 0.02). Conclusion: DISE appears to improve the surgical results of single-level velopharyngeal surgery due to the possibility of excluding patients with obstruction of the base of the tongue, the hypopharynx, and the epiglottis/larynx.

Effectiveness of drug-induced sleep endoscopy in improving outcomes of barbed pharyngoplasty for obstructive sleep apnea surgery: a prospective randomized trial / Iannella, Giannicola; Magliulo, Giuseppe; Cammaroto, Giovanni; Meccariello, Giuseppe; De Vito, Andrea; Pelucchi, Stefano; Ciorba, Andrea; Maniaci, Antonino; Cocuzza, Salvatore; Gulotta, Giampiero; Pace, Annalisa; Corso, Ruggero Massimo; Bahgat, Ahmed; Vicini, Claudio. - In: SLEEP & BREATHING. - ISSN 1522-1709. - (2021). [10.1007/s11325-021-02528-4]

Effectiveness of drug-induced sleep endoscopy in improving outcomes of barbed pharyngoplasty for obstructive sleep apnea surgery: a prospective randomized trial

Iannella, Giannicola
Primo
;
Magliulo, Giuseppe;Gulotta, Giampiero;Pace, Annalisa;
2021

Abstract

Purpose: To observe the effectiveness of preoperative drug-induced sleep endoscopy in improving surgical results of patients undergoing single-level barbed pharyngoplasty surgery for OSA, using a prospective randomized model. Methods: A single-center randomized controlled trial with two prospective arms was carried out to compare functional results in patients treated with barbed reposition pharyngoplasty (BRP) surgery without a preoperative drug-induced sleep endoscopy (DISE) evaluation vs patients treated with BRP surgery performed after DISE evaluation of sites/patterns of collapse. Results: We compared 50 patients who underwent BRP without a preoperative DISE evaluation (Group A) and 42 patients (Group B) treated with BRP surgery but preoperatively selected by means of a preoperative DISE. In this second group of patients, after DISE evaluation, 70% of patients were selected for single-level BRP surgery because they showed an isolated velopharyngeal collapse at the DISE evaluation, without obstruction at other upper airway levels evaluated. Both groups of patients showed a statistically significant difference between preoperative and postoperative values of AHI, ODI, and LOS (p<0.05 in all cases). Comparing Group A and Group B patients, the therapeutic success rate was found to be 60% in patients treated without preoperative DISE evaluation and 83% in patients treated with preoperative DISE (p = 0.02). Conclusion: DISE appears to improve the surgical results of single-level velopharyngeal surgery due to the possibility of excluding patients with obstruction of the base of the tongue, the hypopharynx, and the epiglottis/larynx.
2021
barbed reposition pharyngoplasty; drug-induced sleep endoscopy; OSA surgery; obstructive sleep apnea; randomized controlled trial
01 Pubblicazione su rivista::01a Articolo in rivista
Effectiveness of drug-induced sleep endoscopy in improving outcomes of barbed pharyngoplasty for obstructive sleep apnea surgery: a prospective randomized trial / Iannella, Giannicola; Magliulo, Giuseppe; Cammaroto, Giovanni; Meccariello, Giuseppe; De Vito, Andrea; Pelucchi, Stefano; Ciorba, Andrea; Maniaci, Antonino; Cocuzza, Salvatore; Gulotta, Giampiero; Pace, Annalisa; Corso, Ruggero Massimo; Bahgat, Ahmed; Vicini, Claudio. - In: SLEEP & BREATHING. - ISSN 1522-1709. - (2021). [10.1007/s11325-021-02528-4]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1640638
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