A New Scoring System for Upper Airway Pediatric Sleep Endoscopy

Chan, Dylan K.; Liming, Bryan J.; Horn, David L.; Parikh, Sanjay R.

doi:10.1001/jamaoto.2014.612

Cited by 91 publications

(107 citation statements)

References 23 publications

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“…Most common reported sites of obstruction were the tongue base, adenoids secondary to regrowth, inferior turbinates, velum, and lateral oropharyngeal walls . One study proposed a scoring system to standardize the reporting of DISE outcomes.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of site of obstruction identification and non‐CPAP treatment options for children with persistent pediatric obstructive sleep apnea

et al. 2015

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Drug-induced sleep endoscopy and cine MRI are the most commonly reported tools to identify sites of obstruction for children with persistent OSA; however, these techniques have not yet been clearly linked to outcomes. Evidence for treatment is extremely limited and focuses primarily on lingual tonsillectomy and supraglottoplasty. Also, reports regarding appropriate patient selection and outcomes in obese or otherwise healthy children are scant.

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Section: Resultsmentioning

confidence: 99%

Systematic review of site of obstruction identification and non‐CPAP treatment options for children with persistent pediatric obstructive sleep apnea

et al. 2015

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“…However, it was not intended to be used as an assessment of disease severity or as a prognostic tool and was not validated for this purpose. A similar scoring system described by Chan et al was developed with a goal of standardizing the DISE evaluation in children . The current SERS further builds on their work by adding an assessment of the nasal airway and simplifies its implementation by focusing on only maximal closure with three degrees of obstruction rather than four.…”

Section: Discussionmentioning

confidence: 99%

“…DISE allows direct observation of dynamic airway collapse throughout the pharynx. This technique has previously been shown to be reliable in both adults and children and has been shown to be able to discriminate snorers from nonsnorers …”

Section: Introductionmentioning

confidence: 99%

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Assessment of pediatric obstructive sleep apnea using a drug‐induced sleep endoscopy rating scale

et al. 2016

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“…We have previously described and validated a systematic approach to scoring severity of airway obstruction at five different levels during DISE, including the region of tonsillar obstruction: the lateral pharyngeal wall (Fig. ) . The objective of this study was to compare preoperative Brodsky tonsil score to lateral pharyngeal wall obstruction diagnosed during DISE.…”

Section: Introductionmentioning

confidence: 99%

Clinically small tonsils are typically not obstructive in children during drug‐induced sleep endoscopy

et al. 2016

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Objective To determine whether the degree of lateral pharyngeal wall (LPW) obstruction on pediatric drug-induced sleep endoscopy (DISE) correlates with preprocedure tonsillar hypertrophy score on physical examination, and to determine if clinically small tonsils are obstructive. Methods Retrospective review of 154 patients who underwent DISE at a single pediatric tertiary care center over a 4-year period. Inclusion criteria were documentation of Brodsky tonsil score on preoperative physical examination. Exclusion criteria were previous tonsillectomy, adenoidectomy, or adenotonsillectomy. Lateral pharyngeal wall obstruction was graded for each patient from 0 (no obstruction) to 3 (severe obstruction) using a validated pediatric DISE scoring system known as the Chan-Parikh scoring system (C-P). Data were analyzed using multivariate linear regression controlling for age at time of DISE and presence of comorbid conditions. Results One hundred fifteen patients met criteria for analysis. Median age at DISE was 5.1 years. A moderate positive correlation was calculated between Brodsky score and DISE score, Spearman correlation coefficient 0.55, P = < 0.001. Linear regression modeling determined that for every 1-point increase in tonsil score, there was a 0.7-point increase in C-P LPW score (95% confidence interval [0.45, 0.92]). Sensitivity analysis did not detect a difference in correlation between children with comorbid conditions and children who were otherwise in good health. Of the 65 children with a pre-DISE Brodsky tonsil score of 1, 39 (60%) had a LPW score of 0 (no obstruction); nine (14%) had a score of 1 (< 50% obstruction); 11 (17%) had a score of 2 (> 50% obstruction); and six (9%) had a score of 3 (100% obstruction). Conclusion There is a positive correlation between Brodsky Score and DISE LPW score. The majority of children with sleep-disordered breathing with a Brodsky score of 1 did not demonstrate LPW obstruction. These children may benefit from DISE for identification of alternative sites of upper airway obstruction.

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A New Scoring System for Upper Airway Pediatric Sleep Endoscopy

Cited by 91 publications

References 23 publications

Systematic review of site of obstruction identification and non‐CPAP treatment options for children with persistent pediatric obstructive sleep apnea

Systematic review of site of obstruction identification and non‐CPAP treatment options for children with persistent pediatric obstructive sleep apnea

Assessment of pediatric obstructive sleep apnea using a drug‐induced sleep endoscopy rating scale

Clinically small tonsils are typically not obstructive in children during drug‐induced sleep endoscopy

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