Pheno-DISE being performed with epiglottic pressure catheter in situ
Surgery has an established role in the management of patients with obstructive sleep apnoea. New evidence supports that patients fall into several groups or "phenotypes" underpinned by different mechanisms of airway collapse during sleep and this likely helps to explain why surgery works well in some groups but poorly in others. Surgeons currently use a technique called "Drug induced Sleep Endoscopy" (DISE) to try and determine the site(s) and severity of airway collapse in patients being considered for surgery, yet there is a very real need to improve its reliability and accuracy for predicting surgical success. The recent introduction of hypoglossal nerve stimulation makes this even more relevant. Using novel methods to categorise patients, this project will advance our ability to phenotype patients from a surgical perspective. Our final "pheno-DISE" procedure will more accurately reflect the physical and acoustic properties of the airway during different phases of natural sleep, determine which patients will most likely benefit from surgery and help to predict what type of surgery should be performed to achieve the best outcomes for patients based on their individual phenotype.