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


METHODS
Retrospective case series with medical chart review.


METHODS
Tertiary pediatric medical center.


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


METHODS
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.
Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, USA. mdurr@ohns.ucsf.edu
Megan L
ML
Durr
Anna K
AK
Meyer
Eric J
EJ
Kezirian
Kristina W
KW
Rosbe
D000233:Adenoidectomy; D000293:Adolescent; D000402:Airway Obstruction / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000601:surgery*; D014068:Tonsillectomy; D016896:Treatment Outcome