title: [The impact of sleep endoscopy for obstructive sleep-disordered breathing in children and adolescents].
abstract: OBJECTIVE
  Studies on the surgical treatment of OSAS in adults have shown an improved outcome after targeted therapy by drug-induced sleep endoscopy (DISE). So far, only a few studies have focused on this method in children. The aim of this study is to evaluate the impact of DISE for children with obstructive sleep-disordered breathing and to determine the influence of DISE on treatment recommendations.
  
  
  METHODS
  The medical records of children (n=25) who underwent polysomnography and DISE between 05/2012 and 12/2013 were retrospectively reviewed. The subjects were divided into an UARS (upper airway resistance syndrome)/mild OSAS group (AHI<5; n=10) and a moderate/severe OSAS group (AHI≥5; n=15).
  
  
  RESULTS
  The oropharynx was the most common site of obstruction. Prevalence of complete obstruction at the oropharynx was significantly higher in moderate or severe OSAS (p=0.02). The obstruction pattern of the velopharynx was significantly associated with the size of the adenoids (p=0.02), but tonsil and adenoid size were not related to the severity of OSAS. 71% of children with grade IV tonsils showed complete obstruction of the oropharynx. After DISE, the initial management plan changed in 5 patients (20%).
  
  
  CONCLUSIONS
  DISE is a promising technique to identify sites of obstruction in children with OSAS and to guide treatment decisions. Further studies are needed to predict persistent OSAS based on this tool.
authors: Klinik und Poliklinik für Kinder und Jugendmedizin, Universitätsklinikum Leipzig AöR, Leipzig.
authors: M
authors: M
authors: Quante
authors: Klinik und Poliklinik für Kinder und Jugendmedizin, Universitätsklinikum Leipzig AöR, Leipzig.
authors: A
authors: A
authors: Merkenschlager
authors: Klinik und Poliklinik für Kinder und Jugendmedizin, Universitätsklinikum Leipzig AöR, Leipzig.
authors: W
authors: W
authors: Kiess
authors: Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Leipzig AöR, Leipzig.
authors: I-S
authors: IS
authors: Horn
authors: Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Leipzig AöR, Leipzig.
authors: D
authors: D
authors: Kyas
authors: Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Leipzig AöR, Leipzig.
authors: A
authors: A
authors: Dietz
authors: Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Leipzig AöR, Leipzig.
authors: M
authors: M
authors: Fischer
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology*; D000771:Anesthesia, Intravenous; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004724:Endoscopy; D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D017286:Polysomnography / Q000379:methods*; D015742:Propofol; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000209:etiology*; D014741:Video Recording / Q000379:methods
chemical_list: D015742:Propofol