Novel Intraoral Negative Airway Pressure in Drug-Induced Sleep Endoscopy with Target-Controlled Infusion
| Autor: | Chia-Mo Lin, Yu-Hsuan Kuo, Tien-Jen Liu, Ofer Jacobowitz, Yi Chang, Ying-Shuo Hsu, Feng-Hsiang Chiu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Epiglottis
Supine position target control infusion medicine.medical_treatment Polysomnography tongue collapse OSA Behavioral Neuroscience drug induced sleep endoscopy Nature and Science of Sleep medicine Continuous positive airway pressure iNAP therapy Applied Psychology Original Research medicine.diagnostic_test business.industry velar collapse Airway obstruction medicine.disease Obstructive sleep apnea medicine.anatomical_structure INAP Anesthesia Corrigendum Airway business |
| Zdroj: | Nature and Science of Sleep |
| ISSN: | 1179-1608 |
| Popis: | Background In intermittent negative airway pressure (iNAP) therapy, soft tissues are reshaped into a forward-resting position, thus reducing airway obstruction during sleep. This study investigated the effect of iNAP therapy that was administered during drug-induced sleep endoscopy with target-controlled infusion (TCI-DISE) in patients with obstructive sleep apnea (OSA) intolerant of continuous positive airway pressure (CPAP) therapy. Methods This prospective case series study included 92 patients with polysomnography (PSG)-confirmed OSA who underwent TCI-DISE with iNAP from January 2018 to February 2020 at a tertiary referral hospital. Upper airway obstruction was evaluated and scored using the velum, oropharynx, tongue base, and epiglottis (VOTE) classification. Obstruction severity was assessed multiple times with the patient in the supine position with or without lateral rotation of the head and the application of iNAP therapy, respectively. Results After the application of iNAP therapy in the supine position, obstruction severity decreased significantly: from complete or partial obstruction to partial or no obstruction in 37, 12, and 36 patients (40.2%, 13%, and 39%, respectively) with velar obstruction, oropharyngeal, and tongue base obstruction, respectively. After simultaneously applying iNAP therapy with head rotation, obstruction severity decreased in 47, 43, and 19 patients (51%, 47%, and 21%, respectively) with velar, tongue base, and epiglottic obstruction, respectively. Conclusion In TCI-DISE, we found that iNAP therapy relieved velar, oropharyngeal, and tongue base obstruction in the supine position in some patients. Moreover, iNAP therapy can be combined with positional therapy to alleviate velar, tongue base, and epiglottic obstruction in some patients. TCI-DISE can also be used to screen the possible responders for iNAP therapy because it is less time consuming than PSG. Video Abstract Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/ykZXuCMRUTE |
| Databáze: | OpenAIRE |
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