Drug-induced sleep endoscopy directed surgery improves polysomnography measures in overweight and obese children with obstructive sleep apnea

Filipek, Natalia; Kirkham, Erin M.; Chen, Maida; Cheng, Cheng; Horn, David L.; Johnson, Kaalan; Parikh, Sanjay R.

doi:10.1080/00016489.2020.1863465

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…Specific recommendations include that (i) polysomnography be performed before DISE to confirm OSA, (ii) there is likely limited utility for DISE in children with apnea-hypopnea index <2/h, (iii) DISE is indicated in children with OSA with small tonsils as the finding of partial or complete obstruction seen on endoscopy would suggest indication for tonsillectomy to relief upper airway loading, (iv) DISE may not be useful in healthy patients with adenotonsillar hypertrophy not at risk for persistent OSA, but may be indicated in children at high risk for persistent OSA, (v) DISE is also indicated in patients with postsurgical persistent OSA before additional pharyngeal surgery. 44 The outcomes seen in DISE-directed surgeries are promising as it may benefit patients with comorbid conditions at risk for persistent OSA after adenotonsillectomy, namely patients with obesity, Down Syndrome, and hypotonia, 44,[48][49][50] even if surgically naive. 51 Further prospective investigations could strengthen our understanding of the utility of DISE-directed surgery in an increasingly clinically complex pediatric population.…”

Section: Drug-induced Sleep Endoscopymentioning

confidence: 99%

“…The outcomes seen in DISE‐directed surgeries are promising as it may benefit patients with comorbid conditions at risk for persistent OSA after adenotonsillectomy, namely patients with obesity, Down Syndrome, and hypotonia, 44,48–50 even if surgically naive 51 . Further prospective investigations could strengthen our understanding of the utility of DISE‐directed surgery in an increasingly clinically complex pediatric population.…”

Section: Drug‐induced Sleep Endoscopymentioning

confidence: 99%

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Pediatric pulmonary year in review 2021: Sleep medicine

Okorie

Afolabi‐Brown

Tapia

2022

Pediatric Pulmonology

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Pediatric pulmonology publishes original research, review articles, and case reports on a wide variety of pediatric respiratory disorders. In this article, we summarized the past year's publications in sleep medicine and reviewed selected literature from other journals in this field. We focused on original research articles exploring aspects of sleep‐disordered breathing in patients with underlying conditions such as cystic fibrosis, asthma, and sickle cell disease. We also explored sleep‐disordered breathing risk factors, monitoring, diagnosis, and treatment; and included recent recommendations for drug‐induced sleep endoscopy and ways to monitor and improve PAP adherence remotely.

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Section: Drug-induced Sleep Endoscopymentioning

confidence: 99%

Section: Drug‐induced Sleep Endoscopymentioning

confidence: 99%

Pediatric pulmonary year in review 2021: Sleep medicine

Okorie

Afolabi‐Brown

Tapia

2022

Pediatric Pulmonology

View full text Add to dashboard Cite

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Effects of drug-induced sleep endoscopy in children with conventional obstructive sleep apnea–hypopnea syndrome: a systematic review and meta-analysis

Wang,

Chen,

et al. 2023

Sleep Breath

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Purpose This study aimed to conduct a meta-analysis and systematic review of drug-induced sleep endoscopy (DISE) in pediatric conventional obstructive sleep apnea–hypopnea syndrome (OSAHS) without previous upper airway surgery, or comorbidity, to evaluate the change in treatment strategies and to identify obstructive sites observed during DISE. This study aimed to explore the role of DISE in the management of pediatric conventional OSAHS. Methods A comprehensive search was conducted using both computerized and manual methods to retrieve relevant case studies on DISE-guided treatment of pediatric conventional OSAHS from databases including PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, WF, and VIP database. The search period extended from database inception to January 2023. Strict inclusion and exclusion criteria were applied to select relevant literature, and data extraction was performed accordingly. Meta-analysis was conducted using the Stata 16.0 software. Results A total of 761 patients from four studies were included in the meta-analysis. All pediatric patients had no history of upper airway surgery, craniofacial abnormalities, or syndromes other than OSAHS. The quality assessment revealed that the included studies were of low methodological quality and consisted of non-randomized case studies. Meta-analysis results indicated that in pediatric patients with OSAHS, the obstruction rates observed during DISE were as follows: nasopharyngeal (adenoid) obstruction 93%, soft palate obstruction 35%, oropharyngeal (tonsil) obstruction 76%, tongue base obstruction 32%, supraglottic obstruction 31%, and multi-level obstruction 60%. DISE led to a change in the conventional surgical approach in 45% (95% CI: 29–60%) of patients with OSAHS, providing individualized treatment plans. Postoperative symptoms and sleep-related parameters improved significantly compared to preoperative values, with DISE findings possibly enhancing surgical success rates and potentially avoiding unnecessary procedures. Conclusion In some cases, DISE may potentially lead to alterations in conventional surgical approaches for children with OSAHS who had no history of upper airway surgery, craniofacial abnormalities, or other syndromes.. The results of our meta-analysis were in favor of DISE-directed approach for pediatric conventional OSAHS. However, further high-quality randomized controlled trials (RCTs) are warranted in future research to investigate the role of DISE in the management of pediatric OSAHS.

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