Upper airway assessment in obstructive sleep apnea patients: can computed tomography with lateral cephalometry replace drug-induced sleep endoscopy (DISE)?

Ana Campos, Pedro Cebola, Sara Simões Dias, José Pedro Pais, Susana Sousa, Sérgio Cardoso, João Paço, Cristina Caroça

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To evaluate the association between results from drug-induced sleep endoscopy (DISE) and computed tomography with lateral cephalometry (CTLC) of the pharynx in obstructive sleep apnea (OSA) patients, regarding the same anatomic level, in order to understand if CTLC could replace DISE in selected patients.

STUDY DESIGN: Cross-sectional.

SETTING: Tertiary hospital.

METHODS: A total of 71 patients who attended the Sleep Medicine Consultation in the Otorhinolaryngology Department of Hospital CUF Tejo between 1.6.2019 and 30.9.2021, performed a polysomnographic sleep study and were elected to undergo DISE and CTLC of the pharynx for diagnostic purposes were selected. Obstructions at the same anatomic levels - tongue base, epiglottis and velum - were compared in both exams.

RESULTS: Patients with reduction of epiglottis-pharynx space on CTLC had also a complete obstruction at epiglottis level on the VOTE classification of DISE (p = 0,027). Reduction of velum-pharynx space or tongue base-pharynx space were not related to complete obstruction of the velum (P = 0,623) or the tongue base (p = 0,594) found in DISE. Those with two or more space reductions had a tendency to multilevel obstruction observed in DISE (p = 0.089).

CONCLUSION: When evaluating the obstruction level(s) of an OSA patient, efforts should be made to perform DISE, since CTLC measures, though regarding at the same structures, don´t correlate completely with obstructions observed in DISE.

Original languageEnglish
Pages (from-to)290-297
Number of pages8
JournalActa otorrinolaringologica espanola
Volume74
Issue number5
DOIs
Publication statusPublished - Sept 2023

Keywords

  • Humans
  • Cephalometry
  • Cross-Sectional Studies
  • Sleep Apnea, Obstructive/diagnostic imaging
  • Tomography, X-Ray Computed
  • Endoscopy/methods
  • Sleep

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