Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P150

Sleep Medicine

P150		
Otolaryngology-Head and Neck Surgery 163(1S)
Presentation schedule is subject to change. The Official Program Abstracts supplement does not reflect changes made after August 10, 2020.
patients were 84.6% (11/13) and 30.8% (4/13), respectively,
same-day treatment option for obstructive sleep apnea with
whereas the same data in patients with TCM scores of <14
reduced risk for complications.
were 88.2% (45/51) and 41.2% (21/51), respectively. Only
TCM score showed independent predictive value for surgical
Utility and Safety of Joint Drug-Induced Sleep
success (P < .001, odds ratio [OR] value = 0.456). TCM score
Endoscopy and Cine MRI for Assessment of
and the lowest oxygen saturation both showed independent
Pediatric OSA in the Radiology Suite
predictive values for surgical cure (both P < .05, OR values =
Yann-Fuu Kou, MD (Presenter); Mohamed Mahmoud, MD;
0.467 and 1.082).
Ali Kandil, DO, MPH; Stacey L. Ishman, MD, MPH
Conclusions: Compared with the Friedman staging system,
Objectives: Drug-induced sleep endoscopy (DISE) is traditionthe TCM scoring system is more efficient in choosing proper
ally
performed in the operating room (OR). Cine magnetic resocandidates for velopharyngeal surgery.
nance imaging (MRI) can be performed in conjunction to provide
information regarding sites of obstruction. Our -objective was to
Upper Airway Stimulation: Shorter Hospital
determine the safety of performing both procedures in radiology.
Stays, Fewer Readmissions, and Reduced
Methods: A retrospective chart review was performed on
Emergency Department Presentations
patients who underwent DISE/cine MRI at a pediatric tertiary
Matthew J. Stewart (Presenter); Leonard Estephan;
care center from May 2015 to January 2020. Demographics,
Ashwin Ananth, MD; Joseph Curry, MD; Maurits Boon, MD;
comorbidities, polysomnogram characteristics, and complicaColin T. Huntley, MD
tions were recorded.
Results: Overall, 174 patients underwent DISE/cine MRI: 18
Objectives: Currently, there are few data that compare
in
the
OR and 156 in radiology. There was no significant difpatient outcomes between upper airway stimulation (UAS),
ference
in sex, race, and American Society of Anesthesiologists
expansion sphincter pharyngoplasty (ESP), and transoral
(ASA)
classification
between groups. Patients in radiology
robotic surgery (TORS) for treatment of obstructive sleep
were
significantly
older
(13 vs 8.3 years, P = .04) and had a
apnea. Here, we compare length of stay, readmission rates,
higher
body
mass
index
percentile (81.6% vs 46.4%, P =
and emergency department (ED) presentations in the immedi.003)
than
those
in
the
OR.
There was no significant differate postoperative period among these procedures.
ence
in
comorbidities
between
groups. There was no signifiMethods: This is a retrospective chart review of patients
cant
difference
in
obstructive
sleep
apnea severity (n = 129,
ranging from 2012 to 2019 who received either UAS, ESP, or
P
=
.36)
or
sleep
study
parameters
between
the radiology and
TORS at a single tertiary care institution.
OR
groups,
including
apnea-hypopnea
index
(AHI) (19.9 vs
Results: A total of 196 patients were reviewed: 74 patients
16.9),
obstructive
AHI
(18.8
vs
14.8),
and
O
for UAS, 21 for TORS, and 98 for ESP. Length of stay varied
2 nadir (84.9%
vs
82.6%).
We
had
1
unplanned
admission
in
the OR group,
significantly between procedures: 0 days for UAS, 1.4 days
and
1
patient
had
a
code
event
in
radiology
on induction.
for TORS, and 0.2 days for ESP (P ≤ .0001). ESP had 10 preMore
combined
procedures
were
performed
over time in
sentations to the ED and 10 readmissions, most commonly for
radiology
with
37
of
43
(86.5%)
in
2017
and
63 of 68
oropharyngeal hemorrhage, but also for pain and dehydration.
(92.6%)
in
2019.
TORS had 2 presentations to the ED and 3 readmissions, split
Conclusions: DISE combined with cine MRI can be perbetween dysphagia, dehydration, and pain. UAS had no readformed
safely in radiology, allowing for a single anesthetic
missions and no ED presentations.
exposure
for these procedures. A strong interdisciplinary colConclusions: Upper airway stimulation is a new and increaslaboration
between otolaryngology and anesthesiology has
ingly common procedure for treating obstructive sleep apnea.
allowed
us
to perform the vast majority of DISE/cine MRI in
Although ED presentations and readmissions were relatively
radiology.
low for ESP and TORS, UAS proves to be a safe and effective
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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