(A1209) Evaluating Sleep Apnea Procedures on the Airway Using Drug-induced Sleep Endoscopy: Systematic Review and Meta-Analysis

Introduction: The goal of this study is to characterize drug-induced sleep endoscopy as a method of evaluating the efficacy of sleep apnea surgical procedures.

Methods: Two independent investigators selected studies on sleep apnea surgeries with pre- and post- surgical DISE evaluations. Primary research studies were included, and data that overlapped with another study was excluded. Investigators performed data extraction, quality rating, and risk-of-bias assessment using the ROBINS-I tool. Data was analyzed using comparison of proportions and means.

Studies included in this study were published from 2012 through 2023.

Results: Ultimately, ten studies (N = 320) were included, with 81.2% male (95% CI: 72.0 – 88.9), and an average age of 46.8. Significant reductions in VOTE (velum, oropharynx, tongue, epiglottis) scoring were observed in post-surgical DISE findings at the level of the velum and oropharynx within the palate group (p < 0.05), and at the velum, oropharynx and tongue within the MMA group. There were also accompanying reductions in traditional measures such as apnea-hypopnea index (AHI) and Epworth sleepiness score (ESS). No significant reductions in VOTE scores at any level were observed within the nasal surgery group.

Conclusions: DISE allows clinicians a nuanced view in post-operative changes in upper airway collapse patterns and may provide a unique perspective in the evaluation of surgical outcomes in sleep apnea. Further research should be done to correlate these findings to existing outcomes measures.