Magnetic Resonance Imaging in Obstructive Sleep Apnea
| Status: | Recruiting |
|---|---|
| Conditions: | Insomnia Sleep Studies, Pulmonary, Pulmonary |
| Therapuetic Areas: | Psychiatry / Psychology, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 21 - Any |
| Updated: | 5/2/2018 |
| Start Date: | July 2014 |
| End Date: | July 2020 |
| Contact: | Eric J Kezirian, MD, MPH |
| Email: | eric.kezirian@med.usc.edu |
There is a fundamental gap in the investigators ability to design effective surgical
treatment of obstructive sleep apnea (OSA) for the 30-40% of patients who cannot tolerate
non-surgical treatment. OSA surgery outcomes vary widely, with the chances of a successful
outcome ranging from 5% to 65% for individual or combination procedures. To predict - and
thereby to improve - outcomes, the investigators must determine what predicts surgical
success. This project will compare findings from two evaluations: drug-induced sleep
endoscopy (DISE) and upper airway magnetic resonance imaging (MRI). DISE has demonstrated
important benefits, but it has important limitations. Upper airway MRI is the most complete
evaluation performed during wakefulness, making it conducive to broad application and less
expensive than DISE, but there are no studies utilizing MRI as a surgical evaluation. The
investigators propose a cross-sectional analysis of 40 adult subjects with moderate to severe
OSA. In addition to history, physical examination, and polysomnogram (sleep study), all
subjects will undergo DISE and MRI to characterize the pattern of obstruction. The
investigators will examine the association between DISE and MRI, focusing on specific DISE
findings that have been associated with surgical outcomes. The investigators
multidisciplinary team has substantial expertise and experience in OSA investigation, DISE,
and upper airway MRI.
treatment of obstructive sleep apnea (OSA) for the 30-40% of patients who cannot tolerate
non-surgical treatment. OSA surgery outcomes vary widely, with the chances of a successful
outcome ranging from 5% to 65% for individual or combination procedures. To predict - and
thereby to improve - outcomes, the investigators must determine what predicts surgical
success. This project will compare findings from two evaluations: drug-induced sleep
endoscopy (DISE) and upper airway magnetic resonance imaging (MRI). DISE has demonstrated
important benefits, but it has important limitations. Upper airway MRI is the most complete
evaluation performed during wakefulness, making it conducive to broad application and less
expensive than DISE, but there are no studies utilizing MRI as a surgical evaluation. The
investigators propose a cross-sectional analysis of 40 adult subjects with moderate to severe
OSA. In addition to history, physical examination, and polysomnogram (sleep study), all
subjects will undergo DISE and MRI to characterize the pattern of obstruction. The
investigators will examine the association between DISE and MRI, focusing on specific DISE
findings that have been associated with surgical outcomes. The investigators
multidisciplinary team has substantial expertise and experience in OSA investigation, DISE,
and upper airway MRI.
Inclusion Criteria:
- age ≥ 21 years; moderate to severe OSA (AHI ≥15 events/hour)
- body mass index <40 kg/m2.
Exclusion Criteria:
- prior OSA surgery
- known neurologic, cardiac, pulmonary, renal, or hepatic disorders
- psychiatric problems except for treated depression or mild anxiety
- co-existing sleep disorder other than OSA
- other contraindication to DISE or MRI such as propofol allergy.
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