DISE vs Muller's Maneuver in OSA Assessment

Overview

Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder caused by recurrent upper airway collapse during sleep. Accurate identification of the site and pattern of upper airway obstruction is essential for selecting the appropriate treatment. Müller's maneuver has been widely used as an office-based assessment tool; however, it has limitations in reproducing natural sleep conditions. Drug-Induced Sleep Endoscopy (DISE) allows dynamic visualization of the upper airway under sedated conditions and may provide more accurate information about the level and pattern of airway collapse. This study aims to compare the findings of DISE with Müller's maneuver in patients with obstructive sleep apnea and to evaluate the diagnostic value of both techniques in upper airway assessment.

Obstructive sleep apnea (OSA) is one of the most common sleep-related breathing disorders and is characterized by recurrent episodes of partial or complete upper airway obstruction during sleep, leading to intermittent hypoxia, sleep fragmentation, and significant cardiovascular and metabolic consequences. Accurate localization of the site and pattern of upper airway collapse is essential for selecting the most appropriate treatment strategy. Müller's maneuver is a commonly used office-based endoscopic technique that evaluates upper airway collapse during forced inspiratory effort while the patient is awake. However, its diagnostic accuracy has been questioned because it does not replicate the physiological conditions of natural sleep. Drug-Induced Sleep Endoscopy (DISE) is a dynamic endoscopic examination performed under sedation, allowing direct visualization of the upper airway during a sleep-like state and providing detailed information regarding the level, degree, and configuration of airway collapse. The present prospective study aims to compare the findings of Drug-Induced Sleep Endoscopy with those obtained by Müller's maneuver in patients diagnosed with obstructive sleep apnea. The study will evaluate the agreement between both techniques in identifying the site and pattern of upper airway obstruction and assess the potential additional diagnostic value of DISE in the preoperative assessment and treatment planning of patients with OSA. The findings of this study may help optimize patient selection for individualized therapeutic interventions and improve clinical decision-making in the management of obstructive sleep apnea.