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Sleep · DISE

VOTE Classification

A structured worksheet for recording drug-induced sleep endoscopy findings: degree and configuration of collapse at the velum, oropharyngeal lateral walls, tongue and epiglottis. When you are done you can print a report or copy the findings as plain text for your clinical record.

Baseline assessment

Resting examination, no maneuvers. Score the degree at each structure; configuration becomes available only when the degree is 1 or 2.

Show collapse configuration diagrams
ANTERIOR
AnteroposteriorVelum · Tongue · Epiglottis
ANTERIOR
LateralOropharyngeal walls · Velum · Epiglottis
ANTERIOR
ConcentricVelum

Schematic axial cross-section of the pharynx as seen endoscopically, anterior uppermost. The dashed line represents the resting airway and the dark area the residual lumen during collapse. Original diagrams, not reproductions of published images.

0 no obstruction, no vibration 1 partial, with vibration 2 complete, collapse X not visualized

Structure
Degree of obstruction
Configuration
VVelum soft palate, uvula and lateral pharyngeal wall at the velopharynx
OOropharyngeal lateral walls tonsils and lateral pharyngeal wall tissue
TTongue retroglossal collapse
EEpiglottis folding or posterior displacement

Oropharyngeal lateral wall subtype (optional)

Distinguishes the tonsillar component from the lateral wall tissues. Only meaningful when the oropharynx scores 1 or 2.

VOTE classification

VOTE does not produce a score. The result is a description by structure, not a number: degrees are not summed and there is no cut-off. The assessment is qualitative and interrater agreement is limited, particularly at the velum.

Reassessment during a maneuver Optional. This is a separate, independent VOTE record, not a modification of the baseline: the two are never merged or subtracted.

Maneuver or condition applied

Select the maneuver this second record corresponds to.

Structure
Degree of obstruction
Configuration
VVelum
OOropharyngeal lateral walls
TTongue
EEpiglottis
VOTE during maneuver

On jaw thrust. Maximal protrusion is not advisable: it does not predict oral appliance outcome. Aim to reproduce the protrusion and vertical opening the actual appliance would provide, and if the patient has their own device, examine with it in place and remove it afterwards.

Examination conditions Optional record that does not score. Covers the items the European position paper recommends stating in the report.

Body position during the baseline record

Sedation and monitoring

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