Drug-induced sleep endoscopy: A guide for treatment selection

Identifying the sites, severity, and pattern of upper airway obstruction in obstructive sleep apnea is crucial for determining the treatment options, particularly the surgical plan. Although early methods of assessment, such as Muller's maneuver, computed tomography, and magnetic resonance imaging in awake patients have been utilized to assess obstructive sites, the physiologic and anatomical differences between awake and sleeping patients showed a limited ability of those methods as diagnostic tools. Recently, drug-induced sleep endoscopy (DISE) was introduced as a useful diagnostic and evaluation tool to identify dynamic upper airway collapse during sedation that simulates natural sleep. In this article, we review all aspects of DISE, including the technique, evaluation methods, and clinical application.