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Hospital offers endoscopy to pinpoint airway obstruction before sleep apnea surgery

[May 03 2013] - A new outpatient endoscopy procedure offered at The Hospital of Central Connecticut for sleep apnea sufferers pinpoints site of airway obstruction in preparation for surgery to treat the condition.

The procedure, drug-induced sleep endoscopy (DISE) allows an otolaryngologist to pinpoint site of a patient's airway obstruction that triggers the sleep apnea or lapse in breathing.

"The DISE procedure is much more accurate and much more closely simulates the actual dynamics during sleep because the patient is unconscious with a monitored airway," says otolaryngologist Louis Petcu, M.S., M.D., FACS. Having the endoscopy before surgery can help toward achieving up to a 75 percent success rate in sleep apnea treatment, he says.

Having sleep apnea puts one at risk for automobile and heavy machinery accidents, falls, memory loss, impaired thinking and heart disease, including sudden cardiac death. "Obstructive sleep apnea has been shown to decrease life expectancy significantly if it is not treated," says Petcu.

People who suffer from sleep apnea, marked by episodes of not breathing due to airway obstruction, may use a CPAP (continuous positive airway pressure) device or an oral appliance to treat the condition. For those who cannot tolerate a CPAP device or oral appliance, surgery may be an option.

For the endoscopy, a patient is mildly sedated to induce moderate sleep. The nose is anesthetized and decongested with a spray before a flexible fiberoptic scope is placed in the nose to view the airway and locate obstruction(s). An obstruction may be in the nasal airway; the soft palate, including the uvula; base of tongue; epiglottitis, which is above the windpipe and part of the larynx; or airway walls.

Depending on the surgical site, either traditional or robotic surgery would be performed after DISE results and treatment options have been discussed with the patient. Trans-oral robotic surgery (TORS), a newer surgical offering at HOCC, offers surgery without incision for the tongue and/or part of the cartilage covering the trachea (i.e., epiglottis). TORS enables a physician to maneuver two robotic arms within the surgical area, accessed through the mouth. The surgeon views a magnified, high-resolution 3D image of the surgical site.

The Hospital of Central Connecticut's Sleep Disorders Center tests for and treats varied sleep disorders, including sleep apnea; for more information, please visit http://thocc.org/services/sleep/ .