Drug-Induced Sleep Endoscopy and Surgical Outcomes: A Multicenter Cohort Study.
Drug-Induced Sleep Endoscopy and Surgical Outcomes: A Multicenter Cohort Study.
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DOI：
10.1002/lary.27655
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发表时间：
2019-03
期刊：
影响因子：
--
通讯作者：
Kezirian EJ
中科院分区：
文献类型：
--
作者：
Green KK;Kent DT;D'Agostino MA;Hoff PT;Lin HS;Soose RJ;Boyd Gillespie M;Yaremchuk KL;Carrasco-Llatas M;Tucker Woodson B;Jacobowitz O;Thaler ER;Barrera JE;Capasso R;Liu SY;Hsia J;Mann D;Meraj TS;Waxman JA;Kezirian EJ
在一项大型多中心国际队列研究中，评价采用VOTE分类法对术前药物诱导睡眠内窥镜（DISE）检查进行盲态审查的结果与阻塞性睡眠呼吸暂停（OSA）手术结局之间的相关性。对因OSA接受咽部手术的无扁桃体肥大成人的回顾性、多中心队列研究。这项研究只包括没有扁桃体肿大的参与者。4名独立评审员使用VOTE分类系统对术前DISE视频进行盲态评审，并对导致气道阻塞的主要结构进行评分。通过单变量分析和多元回归分析研究DISE结果与手术结局的相关性。纳入了来自14个中心的275名研究参与者。平均年龄为51.4±11.8岁，体重指数为30.1 ± 5.2 kg/m2。DISE结果的评分者间可靠性中等（kappa = 0.40-0.60）。口咽侧壁相关梗阻与较差的手术结局相关（校正比值比0.51; 95%CI 0.27，0.93）。完全性舌相关梗阻与中重度OSA的手术反应几率较低相关（调整后的比值比0.52; 95%CI 0.28，0.98），其他分析的结果相似，但无显著性意义。手术结果与腭帆相关梗阻的程度和结构或会厌相关梗阻的程度没有明确的相关性。手术反应与扁桃体大小和身体质量指数呈负相关。口咽侧壁和舌的DISE结果可能是这种评估技术的最重要的结果。
To evaluate the association between findings of blinded reviews of preoperative drug-induced sleep endoscopy (DISE) examinations using the VOTE Classification and obstructive sleep apnea (OSA) surgical outcomes in a large multicenter, international cohort. Retrospective, multi-center cohort study of adults without tonsillar hypertrophy who underwent pharyngeal surgery for OSA. The study included only participants without enlarged tonsils. Four independent reviewers performed blinded review of preoperative DISE videos using the VOTE Classification system and scoring of a primary structure contributing to airway obstruction. DISE findings were examined for an association with surgical outcomes with univariate analyses and multiple regression. 275 study participants were included from 14 centers. Mean age was 51.4±11.8 years, and body mass index was 30.1 ± 5.2 kg/m2. There was moderate inter-rater reliability (kappa = 0.40-0.60) for DISE findings. Oropharyngeal lateral wall-related obstruction was associated with poorer surgical outcomes (adjusted odds ratio 0.51; 95% CI 0.27, 0.93). Complete tongue-related obstruction was associated with a lower odds of surgical response in moderate to severe OSA (adjusted odds ratio 0.52; 95% CI 0.28, 0.98), with findings that were similar but not statistically-significant in other analyses. Surgical outcomes were not clearly associated with the degree and configuration of velum-related obstruction or the degree of epiglottis-related obstruction. Surgical response was associated with tonsil size and body mass index (inversely). DISE findings concerning the oropharyngeal lateral walls and tongue may be the most important findings of this evaluation technique.
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影响因子：
2.6
作者：
Soares, Danny;Sinawe, Hadeer;Folbe, Adam J.;Yoo, George;Badr, Safwan;Rowley, James A.;Lin, Ho-Sheng
通讯作者：
Lin, Ho-Sheng
影响因子：
2.6
作者：
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通讯作者：
de Vries, Nico
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Berggren, Diana
影响因子：
3.4
作者：
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通讯作者：
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