Only a few studies have compared the outcomes of patients kept awake during endoscopic examination and subjects submitted to drug-induced sleep endoscopy. This study aimed to compare the endoscopic findings of patients submitted to outpatient endoscopy and endoscopic examination with sedation by propofol based on the Fujita Classification. This cross-sectional cohort study enrolled 34 patients. The subjects underwent ENT examination, nasal endoscopy with Müller's maneuver, and drug-induced sleep endoscopy with propofol. The Fujita Classification was used to compare the two modes of endoscopic examination. The examinations were correlated to patient clinical data such as BMI, age, and OSAS severity. There was no agreement between the two modes of endoscopic examination, whether for the group in general or for the analyzed subgroups. There was no agreement between the endoscopic findings of endoscopic examinations done with the patient awake or in drug-induced sleep.

Study Objectives: Acquiring a better comprehension of obstructive sleep apnea (OSA) physiopathology can contribute to improve patient selection for surgical treatments. We hypothesize that maxillar...

Objective: To examine the accuracy and interrater reliability of a visually assessed vs airflow‐based measure of pharyngeal collapsibility obtained in patients with obstructive sleep apnea undergoing drug‐induced sleep endoscopy (DISE).Study Design: Prospective observational study.Setting: Academic tertiary care practice.Methods: Patients underwent DISE with airflow monitoring and nasal positive airway pressure titration to determine visual and airflow‐based levels of pharyngeal opening pressure (PhOP). Visual DISE‐PhOP was assessed by 2 blinded independent raters and defined as the pressure at which visual confirmation of airway collapse, including snoring, was abolished. Airflow‐based DISE‐PhOP was defined as the minimally effective positive airway pressure that abolished inspiratory flow limitation. Equivalence testing between visual and airflow DISE‐PhOP of each rater was performed with the two one sided T‐test (TOST) with an a priori equivalence bound of ±1 cm H₂O. Interrater reliability was evaluated with the intraclass correlation coefficient.Results: One hundred patients were enrolled in the study and 77 completed the full evaluation. The population was predominantly male (74%) with an average age of 54.8 years, body mass index of 30.1 kg/m², and apnea‐hypopnea index of 30.7 events/h. Equivalence testing showed that both raters were within ±1 cm H₂O of airflow‐based DISE‐PhOP (−0.43 to 0.09 cm H₂O and −0.32 to 0.48 cm H₂O). Interrater reliability of visual DISE‐PhOP between the raters was also good to excellent with an intraclass correlation coefficient of 0.895 (95% CI, 0.84‐0.932).Conclusion: DISE‐PhOP, a measure of upper airway collapsibility, was equivalent between airflow‐based and visual assessments with strong interrater reliability, supporting its adoption as a standardized objective parameter in clinical DISE.

(1) Background: Drug-Induced Sleep Endoscopy (DISE) enables the three-dimensional and dynamic visualization of the upper airway (UA) during sleep, which is useful in selecting the best treatment option for obstructive sleep apnea (OSA) patients, particularly for surgical procedures. Despite international consensus statements or position papers, a universally accepted DISE methodology and classification system remain a controversial open question. (2) Methods: A review of the English scientific literature on DISE related to endoscopic classification systems and surgical outcome predictors (3) Results: Of the 105 articles, 47 were included in the analysis based on their content’s relevance to the searched keywords. (4) Conclusions: A final report and scoring classification system is not universally accepted; the most internationally applied endoscopic classification system during DISE does not cover all patterns of events that occur simultaneously during the endoscopic examination, highlighting that several configurations of collapse and obstruction at different UA levels could be observed during DISE, which should be described in detail if DISE has to be considered in the decision-making process for the UA surgical treatment in OSA patients and if DISE has to have a role as a predictive factor for surgical outcomes analysis.