Drug-induced sleep endoscopy while administering CPAP therapy in patients with CPAP failure
| Autor: | J. A. Hardeman, E. Dieleman, Marcel P. Copper, Christianne C. A. F. M. Veugen |
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| Přispěvatelé: | Otorhinolaryngology and Head and Neck Surgery |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Natural Orifice Endoscopic Surgery Epiglottis medicine.medical_specialty medicine.medical_treatment Jaw-thrust maneuver 03 medical and health sciences 0302 clinical medicine ENT • Original Article Medicine Humans Continuous positive airway pressure Treatment Failure Collapse (medical) Aged Retrospective Studies Sleep Apnea Obstructive Continuous Positive Airway Pressure business.industry Retrospective cohort study Middle Aged medicine.disease Obstructive sleep apnea nervous system diseases respiratory tract diseases Airway Obstruction medicine.anatomical_structure 030228 respiratory system Otorhinolaryngology Anesthesia Drug-induced sleep endoscopy Female Neurology (clinical) medicine.symptom Airway business CPAP failure 030217 neurology & neurosurgery |
| Zdroj: | Sleep and Breathing, 25(1), 391-398. Springer-Verlag Sleep & Breathing = Schlaf & Atmung |
| ISSN: | 1520-9512 |
| Popis: | Study objectives To study the pattern of upper airway collapse in patients with CPAP failure by performing DISE while administering CPAP therapy and to determine the reason for CPAP failure accordingly. Methods This observational retrospective study comprised 30 patients diagnosed with OSA and CPAP failure, who underwent DISE while administering CPAP therapy. During DISE, the upper airway was assessed with and without CPAP therapy using the VOTE classification. Additionally, a jaw thrust maneuver was performed, in order to mimic the effect of an additional mandibular advancement device (MAD) in combination with CPAP therapy. Consequently, the outcome of DISE was translated into a clinically relevant categorization. Results Eleven patients (37%) had a persistent anteroposterior (AP) collapse, including a collapse at velum, tongue base, or epiglottis level and multilevel collapse. Eight patients (27%) had a floppy epiglottis. Five patients (17%) had a persistent complete concentric collapse (CCC) and three patients had a persistent laryngeal collapse (10%). In three patients (10%), no airway collapse was found after CPAP administration. Conclusions Based on the results of the reported study, in most cases, the potential cause of CPAP failure can be determined by this new diagnostic method. Consequently, suggestions can be made for additional therapy. |
| Databáze: | OpenAIRE |
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