Sleep medicine in otolaryngology units: an international survey
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ENT • ORIGINAL ARTICLE
Sleep medicine in otolaryngology units: an international survey Giovanni Cammaroto 1,2 & Giulia Bianchi 3 & Henry Zhang 4 & Vik Veer 4 & Bhik Kotecha 4 & Ofer Jacobowitz 5 & Marina Carrasco Llatas 6 & Paula Martínez Ruiz de Apodaca 6 & Rodolfo Lugo 7 & Giuseppe Meccariello 1 & Giannicola Iannella 1 & Riccardo Gobbi 1 & Song Tar Toh 8 & Ying-Shuo Hsu 9 & Ahmed Yassin Baghat 10 & Jerome R. Lechien 2,11 & Christian Calvo-Henriquez 2,12 & Carlos Chiesa-Estomba 2,13 & Maria Rosaria Barillari 2,14 & Badr Ibrahim 2,15 & Tareck Ayad 2,15 & Nicolas Fakhry 2,16 & Paul Hoff 17 & Eric Rodrigues Thuler 18 & Lyndon Chan 19 & Chloe Kastoer 20 & Madeline Ravesloot 21 & Andrea De Vito 22 & Filippo Montevecchi 1 & Claudio Vicini 1,2 Received: 14 May 2020 / Revised: 16 September 2020 / Accepted: 31 October 2020 # Springer Nature Switzerland AG 2020
Abstract Purpose No study to date has described the overall landscape of sleep disorders management and training in otolaryngology departments of different countries. The aim of our study was to investigate and compare settings, diagnostic and therapeutic approaches and training programmes. Methods An international online survey was developed with the collaboration of the YO-IFOS (Young OtolaryngologistsInternational Federation of Otorhinolaryngological Societies) to assess the current practice of otolaryngologists in the management of sleep disorders. The survey also included a session dedicated to training. Results A total of 126 otolaryngologists completed the survey. The larger part of responses was collected from Central/South America and Europe. The majority of responders from South/Central America (97%) declared to be certified as sleep specialist while 49% of Europeans stated the opposite. Of responders 83% perform a drug-induced sleep endoscopy (DISE) before planning a possible surgical intervention. Soft palate and base of tongue interventions were the most common procedure, respectively performed in 94% and 79% of the cases. Residents were allowed to perform soft palate surgery in 77% of the cases. Upper airway stimulation (26% vs 10%), trans-oral robotic surgery (36% vs 11%) and radiofrequency of the base of the tongue (58% vs 25%) were preferred more frequently by European responders. The highest caseloads of soft palate surgery and bimaxillary advancement were registered in the academic institutions. Conclusion Significant concordance and few interesting divergences in diagnosis and treatment of sleep disorders were observed between nationalities and types of institution. Economic resources might have played a significant role in the therapeutic choice. Trainees’ lack of exposure to certain interventions and to a sufficient caseload appeared to be the main burden to overcome. Keywords OSA . Otolaryngology . Sleep surgery . DISE . Survey
Introduction Snoring and obstructive sleep apnoea (OSA) are frequent sleep disorders affecting a significant percentage of population worldwide. In particular, OSA should be considered a severe medical condition being
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