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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
07:54

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

Endoscopic findings in children with obstructive sleep apnea: effects of age and hypotonia

Shmuel Goldberg1, Anat Shatz, Elie Picard

  • 1Department of Pediatric Pulmonology, Shaare Zedek Medical Center, Jerusalem, Israel. pedpul@szmc.org.il

Pediatric Pulmonology
|June 16, 2005
PubMed

Insights

Dynamic airway abnormalities are common in children with obstructive sleep apnea (OSA), especially in infants and hypotonic children. Identifying these issues before surgery improves treatment outcomes for pediatric OSA.

Area of Science:

  • Pediatric Pulmonology
  • Otolaryngology
  • Sleep Medicine

Background:

  • Obstructive sleep apnea (OSA) is a prevalent pediatric disorder linked to significant morbidity.
  • OSA causes stem from fixed (e.g., adenotonsillar hypertrophy) or dynamic (e.g., laryngomalacia) upper airway issues.

Purpose of the Study:

  • To ascertain the prevalence of dynamic upper airway abnormalities in children with OSA.
  • To compare these findings between normotonic and hypotonic pediatric OSA patients.

Main Methods:

  • Retrospective review of 39 pediatric OSA patients who underwent bronchoscopy.
  • Categorization of patients into normotonic (n=22) and hypotonic (n=17) groups.
  • Analysis of endoscopic findings for dynamic airway defects.

Main Results:

  • Dynamic abnormalities were prevalent in normotonic children, decreasing with age (100% <1yr, 66% 1-2yrs, 17% >2yrs).
  • Dynamic defects were highly prevalent in hypotonic children, irrespective of age.
  • A significant portion of OSA cases involved dynamic defects, alone or combined with fixed issues.

Conclusions:

  • Dynamic upper airway abnormalities are frequent in pediatric OSA, particularly in infants and hypotonic children.
  • Endoscopy may be crucial for diagnosing OSA in these specific pediatric subgroups.
  • Identifying dynamic defects pre-intervention can guide treatment decisions and improve surgical outcomes.

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