Drug-Induced Sleep Endoscopy: Diagnostic and Therapeutic Applications

Review by L Flood
Middlesborough, UK

I somehow missed this when it first appeared, but it is still well worth a review. It is inevitably a slim book, on a very specialised topic, but will be of great interest to those managing sleep disordered breathing. The Editors are from the Netherlands, Belgium and Italy, but there is an international authorship of the 24 chapters. For the UK, Bhik Kotecha and Ivor Swane present a brief early chapter entitled “Historical Perspective”. Drug Induced Sleep Endoscopy (DISE) will always be associated in my mind with the work of Charles Croft, in the nearby Gray’s Inn Rd, although the technique had to face many a sceptic. The concern was always that drug induced sleep was very different to natural sleep and that endoscopic findings might be unrepresentative and not influence management. This book does address this issue very thoroughly and convincingly.

I suspect many of us thought that, with the advent of Continuous Positive Airway Pressure (CPAP), the problem of Obstructive Sleep Apnoea was solved, begging the question then, why perform endoscopy? The Preface justifies the book’s topic as treatment is “gradually and consistently moving away from CPAP only”. The alternatives, whether surgical or conservative, need that extra diagnostic work-up that DISE offers.

There are short and “punchy” chapters, which make for very easy reading and titles such as “Common Mistakes in DISE”, “Complications of DISE” and “Future Perspectives” nicely illustrate the content. Chapters cover endoscopy’s role in selection for mandibular advancement prostheses, upper airway stimulation or transoral robotic surgery. All are then summarised in a chapter entitled “DISE and Treatment Outcome”, but I thought only two pages of text was perhaps too much of a “summary”. Paediatric sleep endoscopy and especially when applied to children with craniofacial abnormalities merits two closing chapters.

As one would expect from this publisher, the book is very well presented, with high quality coloured illustrations. This is one subject where the ten accompanying on-line videos, so often just an afterthought, are invaluable.

Well, I have been a bit late with this review, but the book is a very comprehensive account of the technique and applications of DISE. I freely admit that the cover surprised me, as I was sure this was always performed transnasally, but I know better now after reading this.

Amazon Link: Drug-Induced Sleep Endoscopy: Diagnostic and Therapeutic Applications
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