Outcomes of OSA in surgically naïve young children with and without DISE identified laryngomalacia

Love, Harrison; Slaven, James E.; Mitchell, Ryan M.; Bandyopadhyay, Anuja

doi:10.1016/j.ijporl.2020.110351

Cited by 9 publications

(14 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This disease entity is difficult to identify on awake laryngoscopy alone. 19 In a meta-analysis by Camacho et al, 20 48/62 (77.4%) of children diagnosed with sleep-state laryngomalacia had failed prior AT. Lastly, children who are being evaluated for hypoglossal nerve stimulator (HNS) treatment currently require DISE evaluation to be completed to determine candidacy for this procedure.…”

Section: Indications For Disementioning

confidence: 99%

Pediatric drug‐induced sleep endoscopy: An updated review of the literature

Arganbright

Lee

Weatherly

2021

World j. otorhinolaryngol.-head neck surg.

View full text Add to dashboard Cite

show abstract

Section: Indications For Disementioning

confidence: 99%

Pediatric drug‐induced sleep endoscopy: An updated review of the literature

Arganbright

Lee

Weatherly

2021

World j. otorhinolaryngol.-head neck surg.

View full text Add to dashboard Cite

show abstract

“…Although the value of a dynamic UA evaluation in infants and young children is recognized, only few studies specifically reported on the outcome of treatment directed by UA findings 16,17 . Love et al recently reported on DISE directed treatment outcome in 79 surgically naïve children below 2 years of age 17 .…”

Section: Discussionmentioning

confidence: 99%

Role of upper airway evaluation in the multidisciplinary management of obstructive sleep apnea in children below two years of age

Blancke,

Platteau,

Slosse

et al. 2024

Pediatric Pulmonology

View full text Add to dashboard Cite

BackgroundDiagnosis and treatment of obstructive sleep apnea (OSA) in infants and young children is challenging because of its clinical heterogeneity and lack of age‐specific guidelines.AimWe report the management and treatment outcome of OSA in children below 2 years of age. Treatment decisions were based upon the pattern of upper airway (UA) obstruction, clinical presentation and OSA severity.MethodsRetrospective, non‐randomized observational cohort study at a tertiary center. Children with OSA who underwent an UA evaluation (drug‐induced sleep endoscopy or direct laryngoscopy) were included.ResultsWe studied 100 patients, 57 boys and 43 girls, age 0.72 years (0.0–2.0) and OSA confirmed by polysomnography. Multilevel UA collapse was present in 26%, (adeno)tonsillar hypertrophy in 31% and 21% had laryngomalacia. Laryngomalacia was more common in children below 6 months of age and adenotonsillar hypertrophy was observed mainly in children >1.5 year of age. Surgical and nonsurgical treatment guided by UA findings, improved OSA severity at group level with a significant reduction (p < 0.001) in obstructive apnea/hypopnea index from 10.8/h (2.1–99.1) to 1.7/h (0.0–73.0), an improvement in mean oxygen saturation from 96.9% (88.9–98.4) to 97.4% (92.3–99.0), in minimal oxygen saturation from 85.4% (37.0–96.0) to 88.8% (51.0–95.5) and oxygen desaturation index from 5.1/h (0.2–52.0) to 1.3/h (0.0–47.8).ConclusionMultidisciplinary management of young children with OSA guided by the pattern of UA obstruction and OSA severity, reduces OSA severity. The pattern of UA obstruction changes in the first 2 years of life from a dynamic collapse to structural abnormalities.

show abstract

“…More recently, DISE utilization has expanded for surgically naïve pediatric patients in specific scenarios, such as patients at high risk for persistent OSA (Down syndrome, obesity, neurologic disorders, etc. ), patients with severe OSA yet small tonsils and adenoids, patients with known sleep‐state dependent laryngomalacia; or patients being evaluated as potential candidates for a hypoglossal nerve stimulator procedure 13–16 …”

Section: Introductionmentioning

confidence: 99%

“…), patients with severe OSA yet small tonsils and adenoids, patients with known sleep‐state dependent laryngomalacia; or patients being evaluated as potential candidates for a hypoglossal nerve stimulator procedure. 13 , 14 , 15 , 16 …”

Section: Introductionmentioning

confidence: 99%

“…), patients with severe OSA yet small tonsils and adenoids, patients with known sleep-state dependent laryngomalacia; or patients being evaluated as potential candidates for a hypoglossal nerve stimulator procedure. [13][14][15][16] The purpose of this study is to expand upon the findings of a previous study conducted by the senior author that demonstrated sleep endoscopy's utility in improving surgical outcomes for pediatric OSA.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Drug‐induced sleep endoscopy effect on intraoperative decision making in pediatric sleep surgery: A 2‐year follow up

Frederick

Brandt

Sheyn

2022

Laryngoscope Investig Oto

View full text Add to dashboard Cite

Objective: To further demonstrate sleep endoscopy's utility in improving surgical outcomes for pediatric OSA.Methods: This is a retrospective review of surgically naïve patients <18 years old with diagnosed moderate-severe OSA who underwent DISE at the time of initial sleep surgery.Patients included in final analysis had both preoperative and postoperative polysomnograms. Surgical success was defined as an oAHI decrease by at least one diagnostic category. Residual OSA was defined as any patient with postoperative oAHI >1.Results: A total of 106 patients had preoperative and postoperative polysomnograms. Patients with comorbidities comprised 53.8% of the group. Average BMI% was 88.2, with 75.5% classified as obese. The most common area of collapse was the base of tongue, occurring in 32.1% of patients. There was a statistically significant decrease from the mean preoperative oAHI of 29.7 to the mean postoperative oAHI of 6.6 (p < 0.001). Surgical success occurred in 76.4% of patients. A postoperative oAHI of <5 was achieved in 57.7% of patients with moderate or severe OSA. The average BMI% of patients who met surgical success was 86.4, while the average BMI % of patients who did not was 90.8. A postoperative oAHI of <5 was achieved in 68.4% of patients with a BMI% < 85, compared with 55.2% of patients with a BMI% ≥ 85. Conclusion:This study supports the utilization of DISE during initial surgery for severe sleep apnea in the pediatric population. It was found to effectively aid in significantly reducing surgically naïve patients' mean oAHI.

show abstract

Outcomes of OSA in surgically naïve young children with and without DISE identified laryngomalacia

Cited by 9 publications

References 22 publications

Pediatric drug‐induced sleep endoscopy: An updated review of the literature

Pediatric drug‐induced sleep endoscopy: An updated review of the literature

Role of upper airway evaluation in the multidisciplinary management of obstructive sleep apnea in children below two years of age

Drug‐induced sleep endoscopy effect on intraoperative decision making in pediatric sleep surgery: A 2‐year follow up

Contact Info

Product

Resources

About