Titolo della tesi: Effectiveness of Drug Induced Sleep Endoscopy in improving outcomes of Barbed Pharyngoplasty for Obstructive Sleep Apnea Surgery: a prospective randomized trial
Purpose: To observe the effectiveness of preoperative drug induced sleep endoscopy in improving surgical results of
patients submitted to 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
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 would seem to improve the surgical results of single-level velo-pharyngeal surgery due to the
possibility of excluding patients with obstruction of the base of the tongue, hypopharynx and the epiglottis / larynx.