Drug-induced sleep endoscopy in persistent pediatric sleep-disordered breathing after adenotonsillectomy

Arch Otolaryngol Head Neck Surg. 2012 Jul;138(7):638-43. doi: 10.1001/archoto.2012.1067.

Abstract

Objectives: To demonstrate the feasibility of drug-induced sleep endoscopy (DISE) in the pediatric population and to examine DISE results in children with persistent sleep-disordered breathing (SDB) after tonsillectomy and adenoidectomy (T&A).

Design: Retrospective case series with medical chart review.

Setting: Tertiary pediatric medical center.

Patients: Thirteen pediatric subjects with persistent SDB after T&A are included in the study.

Intervention: Drug-induced sleep endoscopy was per-formed on all patients with documentation of all sites of persistent airway obstruction.

Results: Multilevel upper-airway obstruction was identified in the majority of patients, most commonly related to tongue base obstruction, adenoid regrowth, and/or inferior turbinate hypertrophy. There were no differences among the 4 subgroups.

Conclusions: Findings from DISE suggest that multiple factors contribute to airway obstruction in persistent SDB after T&A. Further research can address the extent to which directed surgical treatment can improve outcomes in these patients.

MeSH terms

  • Adenoidectomy*
  • Adolescent
  • Airway Obstruction / surgery
  • Child
  • Child, Preschool
  • Conscious Sedation*
  • Endoscopy / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Infant
  • Male
  • Retrospective Studies
  • Sleep Apnea Syndromes / surgery*
  • Tonsillectomy*
  • Treatment Outcome