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Guidelines of the French Society of ENT (SFORL): Drug-induced sleep endoscopy in adult obstructive sleep apnea syndrome |
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| Affiliation: | 1. Pôle Tête et Cou, Maison de Santé Protestante de Bordeaux-Bagatelle, 203, route de Toulouse, 33401 Talence, France;2. Clinique Beausoleil, 119, avenue de Lodeve, 34070 Montpellier, France;3. Service d’ORL et de Chirurgie Cervico-Faciale, Hôpital Henri-Mondor, 1, rue Gustave-Eiffel, 94000 Créteil, France;4. Département d’Anesthésie-Réanimation Saint-Éloi, Hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34090 Montpellier, France;5. Département de Pneumologie et de Médecine du Sommeil, CHU d’Angers, 4, rue Larrey, 49100 Angers, France;6. Service d’Anesthésie-Réanimation, Hôpital Pellegrin, CHU Bordeaux, place Amélie-Raba-Léon, 33700 Bordeaux, France;7. Service de Pneumologie, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France;8. Centre Médical Veille Sommeil, 59, avenue de Villiers, 75017 Paris, France;9. Service d’ORL, Hôpital Foch, 40, rue Worth, 92140 Suresnes, France;10. Cabinet d’ORL, 20, rue Parmentier, 92200 Neuilly-sur-Seine, France;11. Service d’ORL et Chirurgie Cervico-Faciale, Hôpital Larrey, 24, chemin de Pouvourville, 31059 Toulouse, France;12. Service d’ORL et Chirurgie Cervico-faciale, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France;13. Cabinet d’ORL, 1, rue des Iris, 41260 La Chaussée-Saint-Victor, France;14. Service d’ORL et de Chirurgie Cervico-Faciale, Hôpital Pellegrin, CHU Bordeaux, place Amélie-Raba-Léon, 33700 Bordeaux, France;15. Service d’ORL, Centre Hospitalier Intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France;p. Nouvelle Clinique Bordeaux Tondu, avenue Jean-Alfonséa, 33270 Floirac, France;q. SFORL, 26, rue Lalo, 75016 Paris, France |
| Abstract: | ObjectivesTo determine the indications, anesthesiological and surgical procedure and interest of drug-induced sleep endoscopy in the treatment of adult obstructive sleep apnea syndrome.DesignA redactional committee of 17 experts was set up. Conflicts of interest were disclosed and followed up throughout the process of drawing up the guidelines. The work received no funding from any firm dealing in health products (drugs or devices). The GRADE (Grading of Recommendations Assessment, Development and Evaluation) method was applied to assess the quality of the data on which the guidelines were founded. It was stressed that strong recommendations should not be made on the basis of poor-quality or insufficient data.MethodsThe committee studied 29 questions on 5 topics: indications and contraindications, anesthetic technique, surgical technique, interpretation and reporting of results, and management guided by results.ResultsExpert review and application of the GRADE method led to 30 guidelines: 10 with high level of evidence (Grade 1+ or 1?), 19 with low level (GRADE 2+ or 2?) and 1 expert opinion.ConclusionExperts fully agreed on the strong guidelines formalizing the indications and modalities of drug-induced sleep endoscopy for adult obstructive sleep apnea syndrome. |
| Keywords: | Obstructive sleep apneas syndrome Drug-induced sleep endoscopy Palatal collapse Propofol DISE Mandibular Advancement Device OSAS Obstructive phenotypes Airway surgery Obstructive sleep apnea syndrome Continuous positive airway pressure treatment Drug-induced sleep endoscopy mandibular advancement device Complete concentric collapse Velum Oropharyngeal Tongue Base Epiglottis bispectral index |
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