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Background Nowadays, continuous positive airway pressure (CPAP) is the main modality for aging cases with obstructive sleep apnea. In the current study, we aimed to evaluate the safety and efficacy of drug-induced sleep endoscopy (DISE) as a new modality for sleep titration. Patients and methods A total of 60 cases diagnosed with obstructive sleep apnea were included. All cases were subjected to complete history taking, physical examination, and assessment by Berlin questionnaire, Epworth sleepiness scale, along with STOP-Bang questionnaire. Patients underwent full-night-attended polysomnography and DISE on the following day. Results Epworth scale had a mean of 10.33, whereas Berlin and STOP-Bang questionnaires had a mean of 2.45 and 5.50, respectively. The mean values are 12.27 in CPAP titration by DISE, 11.43 in CPAP titration by equation, and 12.45 in manual CPAP titration. There was a statistically significant correlation between all the studied methods (P˂0.05). No morbidity or mortality was encountered in the current study. Conclusion Although sleep endoscopy-assisted CPAP titration is an inexpensive technique, it revealed comparable outcomes to traditional CPAP titration.

Background Fiberoptic bronchoscopy (FOB) is used to directly visualize the lumen of the trachea, as well as proximal and distal airways. It can be used to diagnose or treat abnormalities within or adjacent to these airways. However, it is an invasive procedure that may lead to several complications. Minimum-intensity projection (MinIP) in high-resolution computed tomography (CT) of the lungs is particularly useful because multiple lung diseases may present with reduced CT attenuation values. Patients and methods In this study, we included 115 patients admitted to the Chest Department, Mansoura University, Egypt. All patients were subjected to complete history taking, thorough physical examination, routine laboratory investigations, in addition to chest radiograph. CT and FOB were ordered for all cases. Results CT examination of the studied cases revealed mass in 43.5%, delayed resolved pneumonia in 30.4%, and collapse in 13% of cases. Furthermore, either of cavity, narrowing, or collapse was present in 4.3% of cases. Lesions were detected in the left lung in 43.5%, right lung in was 30.4%, and both lungs in 13% of cases. The sensitivity and specificity of MinIP was 69.4 and 100%, respectively, compared with FOB. The positive predictive value was 100%, whereas the negative predictive value was 71.4%, with an accuracy of 82.6%. The sensitivity of MinIP in the diagnosis was different according to the nature of the lesion. We found significant differences when comparing conventional CT with MinIP, especially in collapse, nodules, delayed resolved pneumonia, cavity, and narrowing. However, such a significant difference was not detected in the diagnosis of mass lesions. Conclusion We conclude that MinIP CT is a very important technique for detection of endobronchial lesion compared with conventional CT, and we recommend use of this technique when an endobronchial lesion is suspected.