Drug-induced Sleep Endoscopy In The Diagnosis Of Obstruction Sites In Patients With Obstructive Sleep Apnea Hypopnea Syndrome: A Systematic Review And Meta-Analysis

Objective To investigate the value of video laryngoscope in localization diagnosis of upper airway stricture in obstructive sleep apnea hypopnea syndrome(OSAHS)during drug—induced sleep.Method We searched the MEDLINE(Pub Med)、EMBASE、CCTR(The Cochrane Controlled Clinical Trials Register Database),CNKI,WANG FANG databases for randomized, blined studies according Cochrane systematic review. We search for or case-control articles published between 1975 and 2016 with the value of sleep endoscopy in OSAHS. All kinds of cohort studies between sleep endoscopy and localization diagnosis of upper airway structure in OSAHS were included. All the data would be analyzed by the QUADAS-2 and the software of the Meta-Disc1.4.Result Seven qualitative studies and three quantitative studies were included. According to the QUADAS-2 items: Patient selection Index test Reference standard show high risk of bias; A total of three studies with 175 patients met the inclusion criteria for Meta-analysis.Meta-analysis results show that the merger sensitivity degrees, specific degrees, diagnostic odds ratio, positive likelihood ratio, negative likelihood ratio and 95%CI were 1.0(0.96~1.0)、0.71(0.59~0.81)、212.47(36.07-1251.56)、4.40(1.28~15.16)、0.02(0~0.11). The SROC the area under the concentration-time curve(AUC) for 0.9910; Sleep was induced using intravenous propofol in five studies and midazolam in two. Four studies found that the degree of velopharyngeal and tongue base obstruction was significantly disagreed at DISE and awake examination.Conclusion Because of its high accuracy,sleep endoscopy can be used as an important auxiliary examination and the sensitive indexes for the surgery procedures and Prognosis treatment plan for OSAHS.But more cohort studies are needed for the verification.