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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

[Severe obstructive sleep apnea syndrome in a toddler]

Virginia León Miranda1, Angeles Sánchez Armengol, Aránzazu Ruiz García

  • 1Unidad de Sueño, Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospitales Universitarios Virgen del Rocío, Seville, Spain. virginia_leon@hotmail.com

Archivos De Bronconeumologia
|May 24, 2007
PubMed

Insights

Severe sleep apnea in a child resistant to initial treatments required multiple surgeries. A third adenoidectomy ultimately resolved the persistent breathing issues during sleep.

Area of Science:

  • Pediatric Sleep Medicine
  • Otolaryngology
  • Respiratory Medicine

Background:

  • Obstructive sleep apnea (OSA) in children can significantly impact growth and development.
  • Adenoid hypertrophy is a common cause of pediatric OSA, often treated with adenoidectomy.

Observation:

  • A 3-year-old boy presented with severe snoring, frequent awakenings, intense respiratory effort during sleep, and delayed growth since 15 months.
  • Initial adenoidectomy at 18 months provided temporary relief, with symptom recurrence.
  • A subsequent adenoidectomy with tonsillectomy showed no significant improvement.

Findings:

  • Polysomnography confirmed severe sleep apnea-hypopnea (apnea-hypopnea index of 45).
  • Continuous positive airway pressure (CPAP) improved sleep quality but did not fully resolve symptoms, particularly snoring.
  • A third adenoidectomy was ultimately required to normalize the child's breathing pattern during sleep.

Implications:

  • Recalcitrant pediatric sleep apnea may necessitate multiple surgical interventions.
  • Persistent symptoms after initial surgeries highlight the complexity of airway obstruction.
  • Complete resolution of severe sleep apnea-hypopnea was achieved through a third adenoidectomy, underscoring its potential role in refractory cases.

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