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Updated: May 16, 2026

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

Drug-induced sleep endoscopy for upper airway evaluation in children with obstructive sleep apnea

Seckin O Ulualp1, Peter Szmuk

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9035, USA. seckin.ulualp@utsouthwestern.edu

The Laryngoscope
|November 22, 2012
PubMed

Insights

Drug-induced sleep endoscopy (DISE) reveals the oropharynx/lateral walls as the most common obstruction site in children with obstructive sleep apnea (OSA). Multiple sites, including the velum, are frequently involved, especially in severe cases.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Respiratory Physiology

Background:

  • Obstructive sleep apnea (OSA) is a common condition in children.
  • Identifying the specific sites of upper airway obstruction is crucial for effective treatment.
  • Adenotonsillar hypertrophy is a primary cause, but other factors contribute.

Purpose of the Study:

  • To characterize the anatomical sites and patterns of upper airway obstruction in children with OSA using drug-induced sleep endoscopy (DISE).
  • To correlate obstruction sites with OSA severity and tonsil size.

Main Methods:

  • Retrospective review of medical records for 82 children who underwent DISE for OSA.
  • Data collected included demographics, medical history, BMI, tonsil/adenoid size, and polysomnography results.
  • DISE findings on obstruction location and pattern were analyzed.

Main Results:

  • The oropharynx/lateral walls were the most frequent single site of obstruction (72/82 patients).
  • Multiple sites of obstruction were common, with velum and oropharynx/lateral walls combined being the most frequent combination (67/82 patients).
  • Complete obstruction at the velum and oropharynx/lateral walls was more prevalent in moderate to severe OSA and correlated with smaller tonsil sizes (grades I and II).

Conclusions:

  • DISE is effective in pinpointing upper airway obstruction sites in pediatric OSA beyond adenotonsillar hypertrophy.
  • The oropharynx/lateral walls are the primary site for single-level obstruction.
  • Combined velum and oropharynx/lateral wall obstruction is common in multi-level cases, particularly in severe OSA.
Abstract

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