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title="Wikipedia (it)"> <link rel="EditURI" type="application/rsd+xml" href="//it.wikipedia.org/w/api.php?action=rsd"> <link rel="canonical" href="https://it.wikipedia.org/wiki/DISE"> <link rel="license" href="https://creativecommons.org/licenses/by-sa/4.0/deed.it"> <link rel="alternate" type="application/atom+xml" title="Feed Atom di Wikipedia" href="/w/index.php?title=Speciale:UltimeModifiche&feed=atom"> <link rel="dns-prefetch" href="//meta.wikimedia.org" /> <link rel="dns-prefetch" href="login.wikimedia.org"> </head> <body class="skin--responsive skin-vector skin-vector-search-vue mediawiki ltr sitedir-ltr mw-hide-empty-elt ns-0 ns-subject mw-editable page-DISE rootpage-DISE skin-vector-2022 action-view"><a class="mw-jump-link" href="#bodyContent">Vai al contenuto</a> <div class="vector-header-container"> <header class="vector-header mw-header"> <div class="vector-header-start"> <nav class="vector-main-menu-landmark" aria-label="Sito"> <div id="vector-main-menu-dropdown" class="vector-dropdown vector-main-menu-dropdown vector-button-flush-left vector-button-flush-right" title="Menu principale" > <input type="checkbox" id="vector-main-menu-dropdown-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-main-menu-dropdown" class="vector-dropdown-checkbox " aria-label="Menu principale" > <label id="vector-main-menu-dropdown-label" for="vector-main-menu-dropdown-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-menu mw-ui-icon-wikimedia-menu"></span> <span class="vector-dropdown-label-text">Menu principale</span> </label> <div class="vector-dropdown-content"> <div id="vector-main-menu-unpinned-container" class="vector-unpinned-container"> <div id="vector-main-menu" class="vector-main-menu vector-pinnable-element"> <div class="vector-pinnable-header 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pagina principale [z]" accesskey="z"><span>Pagina principale</span></a></li><li id="n-recentchanges" class="mw-list-item"><a href="/wiki/Speciale:UltimeModifiche" title="Elenco delle ultime modifiche del sito [r]" accesskey="r"><span>Ultime modifiche</span></a></li><li id="n-randompage" class="mw-list-item"><a href="/wiki/Speciale:PaginaCasuale" title="Mostra una pagina a caso [x]" accesskey="x"><span>Una voce a caso</span></a></li><li id="n-nearby-pages-title" class="mw-list-item"><a href="/wiki/Speciale:NelleVicinanze"><span>Nelle vicinanze</span></a></li><li id="n-vetrina" class="mw-list-item"><a href="/wiki/Wikipedia:Vetrina"><span>Vetrina</span></a></li><li id="n-help" class="mw-list-item"><a href="/wiki/Aiuto:Aiuto" title="Pagine di aiuto"><span>Aiuto</span></a></li><li id="n-Sportello-informazioni" class="mw-list-item"><a href="/wiki/Aiuto:Sportello_informazioni"><span>Sportello informazioni</span></a></li> </ul> </div> </div> <div id="p-Comunità" class="vector-menu mw-portlet 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class="vector-menu-content-list"> </ul> </div> </div> <div id="p-vector-user-menu-userpage" class="vector-menu mw-portlet emptyPortlet" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> </ul> </div> </div> <nav class="vector-appearance-landmark" aria-label="Aspetto"> <div id="vector-appearance-dropdown" class="vector-dropdown " title="Modifica la dimensione, la larghezza e il colore del testo" > <input type="checkbox" id="vector-appearance-dropdown-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-appearance-dropdown" class="vector-dropdown-checkbox " aria-label="Aspetto" > <label id="vector-appearance-dropdown-label" for="vector-appearance-dropdown-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-appearance mw-ui-icon-wikimedia-appearance"></span> <span class="vector-dropdown-label-text">Aspetto</span> </label> <div class="vector-dropdown-content"> <div id="vector-appearance-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <div id="p-vector-user-menu-notifications" class="vector-menu mw-portlet emptyPortlet" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> </ul> </div> </div> <div id="p-vector-user-menu-overflow" class="vector-menu mw-portlet" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="pt-sitesupport-2" class="user-links-collapsible-item mw-list-item user-links-collapsible-item"><a data-mw="interface" href="https://donate.wikimedia.org/?wmf_source=donate&wmf_medium=sidebar&wmf_campaign=it.wikipedia.org&uselang=it" class=""><span>Fai una donazione</span></a> </li> <li id="pt-createaccount-2" class="user-links-collapsible-item mw-list-item user-links-collapsible-item"><a data-mw="interface" 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class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-ellipsis mw-ui-icon-wikimedia-ellipsis"></span> <span class="vector-dropdown-label-text">Strumenti personali</span> </label> <div class="vector-dropdown-content"> <div id="p-personal" class="vector-menu mw-portlet mw-portlet-personal user-links-collapsible-item" title="Menu utente" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="pt-sitesupport" class="user-links-collapsible-item mw-list-item"><a href="https://donate.wikimedia.org/?wmf_source=donate&wmf_medium=sidebar&wmf_campaign=it.wikipedia.org&uselang=it"><span>Fai una donazione</span></a></li><li id="pt-createaccount" class="user-links-collapsible-item mw-list-item"><a href="/w/index.php?title=Speciale:CreaUtenza&returnto=DISE" title="Si consiglia di registrarsi e di effettuare l'accesso, anche se 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accesskey="y"><span>contributi</span></a></li><li id="pt-anontalk" class="mw-list-item"><a href="/wiki/Speciale:MieDiscussioni" title="Discussioni sulle modifiche fatte da questo indirizzo IP [n]" accesskey="n"><span>discussioni</span></a></li> </ul> </div> </div> </div> </div> </nav> </div> </header> </div> <div class="mw-page-container"> <div class="mw-page-container-inner"> <div class="vector-sitenotice-container"> <div id="siteNotice"></div> </div> <div class="vector-column-start"> <div class="vector-main-menu-container"> <div id="mw-navigation"> <nav id="mw-panel" class="vector-main-menu-landmark" aria-label="Sito"> <div id="vector-main-menu-pinned-container" class="vector-pinned-container"> </div> </nav> </div> </div> <div class="vector-sticky-pinned-container"> <nav id="mw-panel-toc" aria-label="Indice" data-event-name="ui.sidebar-toc" class="mw-table-of-contents-container vector-toc-landmark"> <div id="vector-toc-pinned-container" class="vector-pinned-container"> <div id="vector-toc" class="vector-toc vector-pinnable-element"> <div class="vector-pinnable-header vector-toc-pinnable-header vector-pinnable-header-pinned" data-feature-name="toc-pinned" data-pinnable-element-id="vector-toc" > <h2 class="vector-pinnable-header-label">Indice</h2> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-pin-button" data-event-name="pinnable-header.vector-toc.pin">sposta nella barra laterale</button> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-unpin-button" data-event-name="pinnable-header.vector-toc.unpin">nascondi</button> </div> <ul class="vector-toc-contents" id="mw-panel-toc-list"> <li id="toc-mw-content-text" class="vector-toc-list-item vector-toc-level-1"> <a href="#" class="vector-toc-link"> <div class="vector-toc-text">Inizio</div> </a> </li> <li id="toc-Indicazioni" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Indicazioni"> <div class="vector-toc-text"> <span class="vector-toc-numb">1</span> <span>Indicazioni</span> </div> </a> <ul id="toc-Indicazioni-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Controindicazioni" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Controindicazioni"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Controindicazioni</span> </div> </a> <ul id="toc-Controindicazioni-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Procedimento" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Procedimento"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Procedimento</span> </div> </a> <ul id="toc-Procedimento-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Varianti" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Varianti"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Varianti</span> </div> </a> <ul id="toc-Varianti-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Note" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Note"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Note</span> </div> </a> <ul id="toc-Note-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Indice" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Indice" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Mostra/Nascondi l'indice" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Mostra/Nascondi l'indice</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">DISE</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Questa voce esiste solo in questa lingua. Aggiungi la voce per altre lingue" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-0" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">Aggiungi lingue</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> </ul> <div class="after-portlet after-portlet-lang"><span class="uls-after-portlet-link"></span><span class="wb-langlinks-add wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:NewItem?site=itwiki&page=DISE" title="Aggiungi collegamento interlinguistico" class="wbc-editpage">Aggiungi collegamenti</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div class="vector-page-toolbar-container"> <div id="left-navigation"> <nav aria-label="Namespace"> <div id="p-associated-pages" class="vector-menu vector-menu-tabs mw-portlet mw-portlet-associated-pages" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="ca-nstab-main" class="selected vector-tab-noicon mw-list-item"><a href="/wiki/DISE" title="Vedi la voce [c]" accesskey="c"><span>Voce</span></a></li><li id="ca-talk" class="new vector-tab-noicon mw-list-item"><a href="/w/index.php?title=Discussione:DISE&action=edit&redlink=1" rel="discussion" class="new" title="Vedi le discussioni relative a questa pagina (la pagina non esiste) [t]" accesskey="t"><span>Discussione</span></a></li> </ul> </div> </div> <div id="vector-variants-dropdown" class="vector-dropdown emptyPortlet" > <input type="checkbox" id="vector-variants-dropdown-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-variants-dropdown" class="vector-dropdown-checkbox " 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href="/w/index.php?title=DISE&veaction=edit" title="Modifica questa pagina [v]" accesskey="v"><span>Modifica</span></a></li><li id="ca-edit" class="collapsible vector-tab-noicon mw-list-item"><a href="/w/index.php?title=DISE&action=edit" title="Modifica il wikitesto di questa pagina [e]" accesskey="e"><span>Modifica wikitesto</span></a></li><li id="ca-history" class="vector-tab-noicon mw-list-item"><a href="/w/index.php?title=DISE&action=history" title="Versioni precedenti di questa pagina [h]" accesskey="h"><span>Cronologia</span></a></li> </ul> </div> </div> </nav> <nav class="vector-page-tools-landmark" aria-label="Strumenti pagine"> <div id="vector-page-tools-dropdown" class="vector-dropdown vector-page-tools-dropdown" > <input type="checkbox" id="vector-page-tools-dropdown-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-tools-dropdown" class="vector-dropdown-checkbox " aria-label="Strumenti" > <label id="vector-page-tools-dropdown-label" 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wikitesto</span></a></li><li id="ca-more-history" class="vector-more-collapsible-item mw-list-item"><a href="/w/index.php?title=DISE&action=history"><span>Cronologia</span></a></li> </ul> </div> </div> <div id="p-tb" class="vector-menu mw-portlet mw-portlet-tb" > <div class="vector-menu-heading"> Generale </div> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="t-whatlinkshere" class="mw-list-item"><a href="/wiki/Speciale:PuntanoQui/DISE" title="Elenco di tutte le pagine che sono collegate a questa [j]" accesskey="j"><span>Puntano qui</span></a></li><li id="t-recentchangeslinked" class="mw-list-item"><a href="/wiki/Speciale:ModificheCorrelate/DISE" rel="nofollow" title="Elenco delle ultime modifiche alle pagine collegate a questa [k]" accesskey="k"><span>Modifiche correlate</span></a></li><li id="t-specialpages" class="mw-list-item"><a href="/wiki/Speciale:PagineSpeciali" title="Elenco di tutte le pagine speciali [q]" accesskey="q"><span>Pagine speciali</span></a></li><li id="t-permalink" class="mw-list-item"><a href="/w/index.php?title=DISE&oldid=121935017" title="Collegamento permanente a questa versione di questa pagina"><span>Link permanente</span></a></li><li id="t-info" class="mw-list-item"><a href="/w/index.php?title=DISE&action=info" title="Ulteriori informazioni su questa pagina"><span>Informazioni pagina</span></a></li><li id="t-cite" class="mw-list-item"><a href="/w/index.php?title=Speciale:Cita&page=DISE&id=121935017&wpFormIdentifier=titleform" title="Informazioni su come citare questa pagina"><span>Cita questa voce</span></a></li><li id="t-urlshortener" class="mw-list-item"><a href="/w/index.php?title=Speciale:UrlShortener&url=https%3A%2F%2Fit.wikipedia.org%2Fwiki%2FDISE"><span>Ottieni URL breve</span></a></li><li id="t-urlshortener-qrcode" class="mw-list-item"><a href="/w/index.php?title=Speciale:QrCode&url=https%3A%2F%2Fit.wikipedia.org%2Fwiki%2FDISE"><span>Scarica codice QR</span></a></li> </ul> </div> </div> <div id="p-coll-print_export" class="vector-menu mw-portlet mw-portlet-coll-print_export" > <div class="vector-menu-heading"> Stampa/esporta </div> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="coll-create_a_book" class="mw-list-item"><a href="/w/index.php?title=Speciale:Libro&bookcmd=book_creator&referer=DISE"><span>Crea un libro</span></a></li><li id="coll-download-as-rl" class="mw-list-item"><a href="/w/index.php?title=Speciale:DownloadAsPdf&page=DISE&action=show-download-screen"><span>Scarica come PDF</span></a></li><li id="t-print" class="mw-list-item"><a href="/w/index.php?title=DISE&printable=yes" title="Versione stampabile di questa pagina [p]" accesskey="p"><span>Versione stampabile</span></a></li> </ul> </div> </div> <div id="p-wikibase-otherprojects" class="vector-menu mw-portlet mw-portlet-wikibase-otherprojects emptyPortlet" > <div class="vector-menu-heading"> In altri progetti </div> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> </ul> </div> </div> </div> </div> </div> </div> </nav> </div> </div> </div> <div class="vector-column-end"> <div class="vector-sticky-pinned-container"> <nav class="vector-page-tools-landmark" aria-label="Strumenti pagine"> <div id="vector-page-tools-pinned-container" class="vector-pinned-container"> </div> </nav> <nav class="vector-appearance-landmark" aria-label="Aspetto"> <div id="vector-appearance-pinned-container" class="vector-pinned-container"> <div id="vector-appearance" class="vector-appearance vector-pinnable-element"> <div class="vector-pinnable-header vector-appearance-pinnable-header vector-pinnable-header-pinned" data-feature-name="appearance-pinned" data-pinnable-element-id="vector-appearance" data-pinned-container-id="vector-appearance-pinned-container" data-unpinned-container-id="vector-appearance-unpinned-container" > <div class="vector-pinnable-header-label">Aspetto</div> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-pin-button" data-event-name="pinnable-header.vector-appearance.pin">sposta nella barra laterale</button> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-unpin-button" data-event-name="pinnable-header.vector-appearance.unpin">nascondi</button> </div> </div> </div> </nav> </div> </div> <div id="bodyContent" class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">Da Wikipedia, l'enciclopedia libera.</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="it" dir="ltr"><style data-mw-deduplicate="TemplateStyles:r139255918">.mw-parser-output .avviso-mini{border:1px solid #aaa;background-color:#fbfbfb;margin-bottom:.5em;padding:0 2px 0 3px;margin:5px 10%;font-size:90%}.mw-parser-output .avviso-mini>div:first-of-type{margin:2px 2px 2px 0}.mw-parser-output .avviso-mini .mw-collapsible-content{padding:2px 0 0 7px}.mw-parser-output .avviso-mini-informazioni{border-left:10px solid #1e90ff}.mw-parser-output .avviso-mini-contenuto{border-left:10px solid #f28500}.mw-parser-output .avviso-mini-stile{border-left:10px solid #f4c430}.mw-parser-output .avviso-mini-statico{border-left:10px solid limegreen}.mw-parser-output .avviso-mini-struttura{border-left:10px solid #9932cc}.mw-parser-output .avviso-mini-generico{border-left:10px solid #bba}body.skin-minerva .mw-parser-output .avviso-mini{border:none;margin-bottom:1px;padding:inherit}body.skin-minerva .mw-parser-output .avviso-mini .mbox-text-div{font-style:normal}html.client-js body.skin-minerva .mw-parser-output .avviso-mini>div{padding:8px 8px 8px 32px!important;position:relative}</style><div class="ambox avviso-mini noprint metadata avviso-mini-informazioni mw-collapsible mw-collapsed plainlinks"> <div class="mbox-text"> <div class="mbox-text-div" style="display:flex; flex-direction:row; align-items:center; column-gap:5px;"><span class="mbox-image"><span typeof="mw:File"><span title="Questa voce è orfana"><img alt="Questa voce è orfana" src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2e/Arrows-orphan.svg/19px-Arrows-orphan.svg.png" decoding="async" width="19" height="18" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2e/Arrows-orphan.svg/29px-Arrows-orphan.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/2e/Arrows-orphan.svg/38px-Arrows-orphan.svg.png 2x" data-file-width="76" data-file-height="72" /></span></span></span><span style="width:100%"><b>Questa voce è <a href="/wiki/Wikipedia:Pagina_orfana" title="Wikipedia:Pagina orfana">orfana</a></b>, ovvero <a href="/wiki/Speciale:PuntanoQui/DISE" title="Speciale:PuntanoQui/DISE">priva</a> di <a href="/wiki/Aiuto:Wikilink" title="Aiuto:Wikilink">collegamenti</a> in entrata da altre voci.</span></div> </div> <div class="mw-collapsible-content"><a href="/wiki/Wikipedia:Pagina_orfana#Disorfanizzare" title="Wikipedia:Pagina orfana">Inseriscine</a> almeno uno pertinente e utile e rimuovi l'avviso. Segui i suggerimenti del <a href="/wiki/Progetto:Medicina" title="Progetto:Medicina">progetto di riferimento</a>.</div> </div> <style data-mw-deduplicate="TemplateStyles:r139142988">.mw-parser-output .hatnote-content{align-items:center;display:flex}.mw-parser-output .hatnote-icon{flex-shrink:0}.mw-parser-output .hatnote-icon img{display:flex}.mw-parser-output .hatnote-text{font-style:italic}body:not(.skin-minerva) .mw-parser-output .hatnote{border:1px solid #CCC;display:flex;margin:.5em 0;padding:.2em .5em}body:not(.skin-minerva) .mw-parser-output .hatnote-text{padding-left:.5em}body.skin-minerva .mw-parser-output .hatnote-icon{padding-right:8px}body.skin-minerva .mw-parser-output .hatnote-icon img{height:auto;width:16px}body.skin--responsive .mw-parser-output .hatnote a.new{color:#d73333}body.skin--responsive .mw-parser-output .hatnote a.new:visited{color:#a55858}</style> <div class="hatnote noprint disclaimer"> <div class="hatnote-content"><span class="noviewer hatnote-icon" typeof="mw:File"><span><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f7/Nuvola_apps_important.svg/18px-Nuvola_apps_important.svg.png" decoding="async" width="18" height="15" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f7/Nuvola_apps_important.svg/27px-Nuvola_apps_important.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f7/Nuvola_apps_important.svg/36px-Nuvola_apps_important.svg.png 2x" data-file-width="600" data-file-height="500" /></span></span> <span class="hatnote-text">Le informazioni riportate non sono consigli medici e potrebbero non essere accurate. I contenuti hanno solo fine illustrativo e non sostituiscono il parere medico: <a href="/wiki/Wikipedia:Disclaimer_medico" title="Wikipedia:Disclaimer medico">leggi le avvertenze</a>.</span></div> </div> <p>La <b>DISE</b> (dall'inglese <i>Drug Induced Sleep Endoscopy</i>), chiamata anche <i><b>sleep endoscopy</b></i>, è un esame <a href="/wiki/Endoscopia" title="Endoscopia">endoscopico</a> per la diagnosi dei <a href="/wiki/Disturbi_respiratori_nel_sonno" class="mw-redirect" title="Disturbi respiratori nel sonno">disturbi respiratori del sonno</a>.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> La procedura consiste nell’induzione del <a href="/wiki/Sonno" title="Sonno">sonno</a> grazie ad un <a href="/wiki/Farmaco_ipnotico" class="mw-redirect" title="Farmaco ipnotico">farmaco ipnotico</a> che addormenta il paziente, seguito da una valutazione endoscopica della <a href="/wiki/Ventilazione_(fisiologia)" class="mw-redirect" title="Ventilazione (fisiologia)">respirazione</a>; tale metodica fornisce informazioni sulle vie aeree superiori nel caso di restringimento o di ostruzione, nella patologia delle apnee ostruttive del sonno (<a href="/wiki/Sindrome_delle_apnee_nel_sonno" title="Sindrome delle apnee nel sonno">OSA</a>) e del <a href="/wiki/Russamento" class="mw-redirect" title="Russamento">russamento</a>. </p><p>Tale metodica dovrebbe essere eseguita in selezionati pazienti quando questo esame aggiunga informazioni effettivamente utili.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Indicazioni">Indicazioni</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=DISE&veaction=edit&section=1" title="Modifica la sezione Indicazioni" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=DISE&action=edit&section=1" title="Edit section's source code: Indicazioni"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>La DISE fornisce informazioni aggiuntive sulle vie aeree superiori, sul tipo di restringimento che le vede coinvolte e sull'ostruzione in caso di <a href="/wiki/Apnea_ostruttiva_del_sonno" class="mw-redirect" title="Apnea ostruttiva del sonno">apnea ostruttiva del sonno</a> (OSA) nonché sul russamento. La metodica pertanto dovrebbe essere eseguita solo in pazienti selezionati, nei quali le informazioni aggiuntive ottenibili dalla sua applicazione sono considerate un valore aggiunto per il successivo trattamento del paziente. Tradizionalmente la valutazione delle <a href="/wiki/Vie_aeree_superiori" class="mw-redirect" title="Vie aeree superiori">vie aeree superiori</a> viene eseguita con paziente cosciente. Secondo alcuni studi la DISE, rispetto alle valutazioni ottenibili con paziente vigile, può portare a modificazioni del piano di trattamento chirurgico fino in circa il 50% dei pazienti con OSA.<sup id="cite_ref-pmid26484801_3-0" class="reference"><a href="#cite_note-pmid26484801-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Controindicazioni">Controindicazioni</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=DISE&veaction=edit&section=2" title="Modifica la sezione Controindicazioni" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=DISE&action=edit&section=2" title="Edit section's source code: Controindicazioni"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>La DISE dovrebbe essere eseguita in soggetti con un profilo di rischio anestetico accettabile. Le controindicazioni assolute sono date da un punteggio ASA 4, dalla <a href="/wiki/Gravidanza" title="Gravidanza">gravidanza</a> e da allergia nota agli agenti sedativi utilizzati nella procedura. L'obesità patologica rappresenta una controindicazione relativa, in considerazione che spesso questa condizione comporta che i soggetti affetti non possano essere considerati dei buoni candidati per la chirurgia delle vie aeree superiori o la terapia con apparecchi orali (OAT). Nel caso di obesità patologica e prima dell'esecuzione dell'esame si impone pertanto un'attenta considerazione delle opzioni di trattamento chirurgico. </p> <div class="mw-heading mw-heading2"><h2 id="Procedimento">Procedimento</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=DISE&veaction=edit&section=3" title="Modifica la sezione Procedimento" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=DISE&action=edit&section=3" title="Edit section's source code: Procedimento"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>La DISE deve essere eseguita in ambiente clinico protetto (es. sala operatoria, sala di endoscopia, altro ambiente clinico che sia stato allestito con apparecchiature anestetiche standard) dove si possa effettuare il monitoraggio del paziente (es. monitoraggio cardiologico di base, monitoraggio <a href="/wiki/Pressione_arteriosa" class="mw-redirect" title="Pressione arteriosa">pressione arteriosa</a> e saturazione d'ossigeno, kit rianimatorio di base in caso di emergenza). Normalmente la procedura avviene in condizione di day-hospital, anche se, in alcuni casi, può essere necessario prevedere di trattenere il paziente per una notte in ospedale (in base alle condizioni cliniche generali del paziente e all'attuazione o meno di manovre di tipo chirurgico). L'equipe prevede la presenza dell'endoscopista, di un anestesista e di un altro sanitario il cui compito è monitorare il paziente e la sua risposta all'anestesia e alle varie fasi della procedura. L'anestesista induce il sonno tramite un farmaco sedativo (ad esempio il <a href="/wiki/Propofol" title="Propofol">propofol</a>) e spinge il paziente al <a href="/wiki/Russamento" class="mw-redirect" title="Russamento">russamento</a> o ad andare in apnea. La profondità della sedazione può essere controllata mediante uno strumento dedicato (il <a href="/w/index.php?title=Bispectral_Index&action=edit&redlink=1" class="new" title="Bispectral Index (la pagina non esiste)">Bispectral Index</a> -BIS). A questo punto l'endoscopista (spesso un medico <a href="/wiki/Otorinolaringoiatra" class="mw-redirect" title="Otorinolaringoiatra">otorinolaringoiatra</a>) introduce attraverso una fossa nasale l'endoscopio a fibre ottiche connesso ad una telecamera e ad un monitor. Sebbene non sia obbligatorio, un supporto digitale di registrazione (con o senza audio) è auspicabile perché permette l'archiviazione delle immagini e il successivo utilizzo dei filmati video per ricerca, consultazione di altri specialisti e per scopi educativi. </p><p>Talvolta in preparazione all'esame può risultare opportuno eseguire alcune misure preparatorie comprendenti la decongestionante nasale, l'anestesia nasale locale e l'utilizzo di farmaci antisecretori.<sup id="cite_ref-pmid18941765_4-0" class="reference"><a href="#cite_note-pmid18941765-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid15790683_5-0" class="reference"><a href="#cite_note-pmid15790683-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Varianti">Varianti</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=DISE&veaction=edit&section=4" title="Modifica la sezione Varianti" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=DISE&action=edit&section=4" title="Edit section's source code: Varianti"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>La aDISE (<i>auditory Drug Induced Sleep Endoscopy</i>) è una recente variazione, facente parte delle "DISE avanzate" o <i>advanced DISE</i>, che utilizza i <a href="/wiki/Potenziali_evocati" title="Potenziali evocati">potenziali evocati</a> come metodo per la valutazione della <a href="/wiki/Sedazione" title="Sedazione">sedazione</a> in corso di DISE.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Note">Note</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=DISE&veaction=edit&section=5" title="Modifica la sezione Note" class="mw-editsection-visualeditor"><span>modifica</span></a><span class="mw-editsection-divider"> | </span><a href="/w/index.php?title=DISE&action=edit&section=5" title="Edit section's source code: Note"><span>modifica wikitesto</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-references-wrap"><ol class="references"> <li id="cite_note-1"><a href="#cite_ref-1"><b>^</b></a> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Cherry Nzekwu e Esuabom Dijemeni, <a class="external text" href="https://www.wikidata.org/wiki/Q88242524"><span style="font-style:italic;">Drug-Induced Sleep Endoscopy (DISE) Scoring Systems: Ideal DISE Scoring System and Comparability Properties</span></a>, in <span style="font-style:italic;">Otolaryngology-Head and Neck Surgery</span>, vol. 158, n. 4, 1º aprile 2018, p. 777, <a href="/wiki/Digital_object_identifier" title="Digital object identifier">DOI</a>:<a rel="nofollow" class="external text" href="https://dx.doi.org/10.1177%2F0194599817753603">10.1177/0194599817753603</a>. <small>URL consultato il 16 marzo 2021</small>.</cite></span> </li> <li id="cite_note-2"><a href="#cite_ref-2"><b>^</b></a> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Andrea De Vito, Marina Carrasco Llatas e Madeline J. Ravesloot, <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30133943/"><span style="font-style:italic;">European position paper on drug-induced sleep endoscopy: 2017 Update</span></a>, in <span style="font-style:italic;">Clinical otolaryngology: official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery</span>, vol. 43, n. 6, 12 2018, pp. 1541-1552, <a href="/wiki/Digital_object_identifier" title="Digital object identifier">DOI</a>:<a rel="nofollow" class="external text" href="https://dx.doi.org/10.1111%2Fcoa.13213">10.1111/coa.13213</a>. <small>URL consultato il 16 marzo 2021</small>.</cite></span> </li> <li id="cite_note-pmid26484801-3"><a href="#cite_ref-pmid26484801_3-0"><b>^</b></a> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Certal VF, Pratas R, Guimarães L, Lugo R, Tsou Y, Camacho M, Capasso R, <a rel="nofollow" class="external text" href="https://oadoi.org/10.1002/lary.25722"><span style="font-style:italic;">Awake examination versus DISE for surgical decision making in patients with OSA: A systematic review</span></a>, in <span style="font-style:italic;">Laryngoscope</span>, vol. 126, n. 3, Marzo 2016, pp. 768–74, <a href="/wiki/Digital_object_identifier" title="Digital object identifier">DOI</a>:<a rel="nofollow" class="external text" href="https://dx.doi.org/10.1002%2Flary.25722">10.1002/lary.25722</a>, <a href="/wiki/PMID" title="PMID">PMID</a> <a rel="nofollow" class="external text" href="//www.ncbi.nlm.nih.gov/pubmed/26484801">26484801</a>. <small>URL consultato il 18 maggio 2021</small>.</cite></span> </li> <li id="cite_note-pmid18941765-4"><a href="#cite_ref-pmid18941765_4-0"><b>^</b></a> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Hewitt RJ, Dasgupta A, Singh A, Dutta C, Kotecha BT, <a rel="nofollow" class="external text" href="https://oadoi.org/10.1007/s00405-008-0831-5"><span style="font-style:italic;">Is sleep nasendoscopy a valuable adjunct to clinical examination in the evaluation of upper airway obstruction?</span></a>, in <span style="font-style:italic;">Eur Arch Otorhinolaryngol</span>, vol. 266, n. 5, Maggio 2009, pp. 691–7, <a href="/wiki/Digital_object_identifier" title="Digital object identifier">DOI</a>:<a rel="nofollow" class="external text" href="https://dx.doi.org/10.1007%2Fs00405-008-0831-5">10.1007/s00405-008-0831-5</a>, <a href="/wiki/PMID" title="PMID">PMID</a> <a rel="nofollow" class="external text" href="//www.ncbi.nlm.nih.gov/pubmed/18941765">18941765</a>. <small>URL consultato il 24 maggio 2021</small>.</cite></span> </li> <li id="cite_note-pmid15790683-5"><a href="#cite_ref-pmid15790683_5-0"><b>^</b></a> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Doherty LS, Nolan P, McNicholas WT, <a rel="nofollow" class="external text" href="https://oadoi.org/10.1152/japplphysiol.01221.2004"><span style="font-style:italic;">Effects of topical anesthesia on upper airway resistance during wake-sleep transitions</span></a>, in <span style="font-style:italic;">J Appl Physiol (1985)</span>, vol. 99, n. 2, Agosto 2005, pp. 549–55, <a href="/wiki/Digital_object_identifier" title="Digital object identifier">DOI</a>:<a rel="nofollow" class="external text" href="https://dx.doi.org/10.1152%2Fjapplphysiol.01221.2004">10.1152/japplphysiol.01221.2004</a>, <a href="/wiki/PMID" title="PMID">PMID</a> <a rel="nofollow" class="external text" href="//www.ncbi.nlm.nih.gov/pubmed/15790683">15790683</a>. <small>URL consultato il 24 maggio 2021</small>.</cite></span> </li> <li id="cite_note-6"><a href="#cite_ref-6"><b>^</b></a> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Michele Arigliani, Domenico M. Toraldo e Filippo Montevecchi, <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32549340/"><span style="font-style:italic;">A New Technological Advancement of the Drug-Induced Sleep Endoscopy (DISE) Procedure: The "All in One Glance" Strategy</span></a>, in <span style="font-style:italic;">International Journal of Environmental Research and Public Health</span>, vol. 17, n. 12, 06 15, 2020, <a href="/wiki/Digital_object_identifier" title="Digital object identifier">DOI</a>:<a rel="nofollow" class="external text" href="https://dx.doi.org/10.3390%2Fijerph17124261">10.3390/ijerph17124261</a>. <small>URL consultato il 16 marzo 2021</small>.</cite></span> </li> <li id="cite_note-7"><a href="#cite_ref-7"><b>^</b></a> <span class="reference-text"><cite class="citation pubblicazione" style="font-style:normal"> Michele Arigliani, Domenico M. Toraldo e Enrico Ciavolino, <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/33672569/"><span style="font-style:italic;">The Use of Middle Latency Auditory Evoked Potentials (MLAEP) as Methodology for Evaluating Sedation Level in Propofol-Drug Induced Sleep Endoscopy (DISE) Procedure</span></a>, in <span style="font-style:italic;">International Journal of Environmental Research and Public Health</span>, vol. 18, n. 4, 20 febbraio 2021, <a href="/wiki/Digital_object_identifier" title="Digital object identifier">DOI</a>:<a rel="nofollow" class="external text" href="https://dx.doi.org/10.3390%2Fijerph18042070">10.3390/ijerph18042070</a>. <small>URL consultato il 16 marzo 2021</small>.</cite></span> </li> </ol></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?useformat=desktop&type=1x1&usesul3=0" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Estratto da "<a dir="ltr" href="https://it.wikipedia.org/w/index.php?title=DISE&oldid=121935017">https://it.wikipedia.org/w/index.php?title=DISE&oldid=121935017</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Categoria:Categorie" title="Categoria:Categorie">Categorie</a>: <ul><li><a href="/wiki/Categoria:Otorinolaringoiatria" title="Categoria:Otorinolaringoiatria">Otorinolaringoiatria</a></li><li><a href="/wiki/Categoria:Procedure_diagnostiche" title="Categoria:Procedure diagnostiche">Procedure diagnostiche</a></li></ul></div><div id="mw-hidden-catlinks" class="mw-hidden-catlinks mw-hidden-cats-hidden">Categorie nascoste: <ul><li><a href="/wiki/Categoria:Voci_con_modulo_citazione_e_parametro_pagine" title="Categoria:Voci con modulo citazione e parametro pagine">Voci con modulo citazione e parametro pagine</a></li><li><a href="/wiki/Categoria:Pagine_orfane_-_medicina" title="Categoria:Pagine orfane - medicina">Pagine orfane - medicina</a></li><li><a href="/wiki/Categoria:Pagine_orfane_-_aprile_2021" title="Categoria:Pagine orfane - aprile 2021">Pagine orfane - aprile 2021</a></li><li><a href="/wiki/Categoria:Voci_con_disclaimer_medico" title="Categoria:Voci con disclaimer medico">Voci con disclaimer medico</a></li></ul></div></div> </div> </main> </div> <div class="mw-footer-container"> <footer id="footer" class="mw-footer" > <ul id="footer-info"> <li id="footer-info-lastmod"> Questa pagina è stata modificata per l'ultima volta il 17 lug 2021 alle 14:36.</li> <li id="footer-info-copyright">Il testo è disponibile secondo la <a rel="nofollow" class="external text" href="https://creativecommons.org/licenses/by-sa/4.0/deed.it">licenza Creative Commons Attribuzione-Condividi allo stesso modo</a>; possono applicarsi condizioni ulteriori. 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