Dynamic Sleep endoscopy, also known as sleep nasoendoscopy or drug-induced sleep endoscopy , is a useful investigation for studying the upper airway in a sleeping patient with obstructive sleep apnea (OSA). Using the knowledge gained from sleep endoscopy, the surgeon can tailor the operative procedure to the patient’s specific condition.Using midazolam or propofol as a sedating agent, the surgeon or the anesthetist as in this case demonstrate the sites of obstruction and grade them.Grading was based on whether the obstruction was palatal, multilevel, or tongue-based.
Based on the level and pattern of airway obstruction in a patient with OSA, sleep endoscopy allows the surgeon to tailor the treatment plan to each patient. This can improve the results of surgical intervention and/or minimize the scope of intervention.
For many years, the primary surgical treatment for obstructive sleep apnea was soft palate surgery, and this worked well for patients with blockage of breathing in the palate region alone. Unfortunately, many patients also appear to have blockage of breathing in the tongue region, and multiple procedures have been developed to address this in the hope of improving surgical outcomes.
(During drug-induced sleep endoscopy, patients receive sedation administered by an anesthetist in the operating room. As patients begin to snore and have some blockage of their breathing, Dr.Thomas passes a flexible telescope through one side of the nose in order to evaluate the throat and observe the potential blockage of breathing in the palate and tongue regions).